Employers
You hold the risk. You should see the price.
Self-funded employers pay claims out of their own money. ESC100 administers the plan so that what leaves the account is a defensible number, and so employees are not the ones absorbing the argument.
The argument
A network discount is a discount off a number the hospital chose
Chargemaster rates are set by the facility and vary widely for identical care. A large percentage off an arbitrary charge is still an arbitrary payment. Reference-based pricing starts from a published cost basis instead and sets the allowed amount from there.
The result is a plan cost you can forecast and explain to a finance committee, with every claim traceable back to the methodology that priced it. [[STAT: average plan savings vs prior carrier]]
Employees keep access to care. Where a contracted rate is already reasonable, a dual-network plan design uses it. The benchmark is applied where it changes the answer.
What you get
Claims administration
Adjudication, payment, and appeals under your plan document.
Eligibility and billing
Enrollment maintenance, carrier and vendor feeds, and monthly invoicing that reconciles.
Member support
A staffed line for members, including balance-bill defense.
Reporting
Monthly plan performance and a renewal package built for review.
Social proof
What clients say
[[TESTIMONIAL 1]]
[[TESTIMONIAL 2]]
[[TESTIMONIAL 3]]
Request a plan review.
Send your plan document, current funding arrangement, and twelve months of claims experience. We will price a sample and show you the methodology behind every line.