We reduce the cost of covered procedures by an average of 50%
PriceMDs NearCare™ Cost Containment Solution
PRICEMDS NearCare™ COST CONTAINMENT
NearCare™ Cost Relief for Self-Funded Plans
and their Members
"Employer premiums and deductibles are rising much faster than wages"
PriceMDs’ solution to the rising costs is a simple, single bill for all of the surgical cost components that lowers the cost to the plan and often eliminates all out-of-pocket costs for plan members.
CASE STUDY: SAMPLE CLIENT
PMDs Bundled Surgery Solution
The Bundled Surgery program provides all inclusive, low cost bundled pricing, enabling substantial savings on more than 400 outpatient elective surgical procedures. The number of plan members who participate receive a high standard of care, and substantially better outcomes.
SINGLE KNEE REPLACEMENT
PRICEMDS NearCare™ COST CONTAINMENT
We simplify the administration
of elective surgery,
lower the cost,
and improve outcomes.
PriceMDs’ Bundled Surgical Services cover more than 400 outpatient procedures and saves plan providers an average of 50%.
PRICEMDS NearCare™ COST CONNTAINMENT
PriceMDs clients can save big on bundled procedures.
Let us show you the power of our directory that saves plan providers an average of 50%
PriceMDs’ NearCare™ Cost Containment solution offers choice and access to more than 3,600 quality facilities located across the US.
Our team of Registered Nurses, Care Coordinators, and Client Service Account Managers provide high-level support and management for our clients and their members.
PRICEMDS NearCare™ COST CONTAINMENT
Imaging and NearCare™
PriceMDs currently works around the US and in your neighborhood – what PriceMDs calls NearCare™
PriceMDs serves clients and patients in 48 states through a directory of 3,600+ facilities. Our medical concierge staff of registered nurses will make it easy for your members to access quality, affordable care.
PriceMDs and our imaging partners will assist patients in making informed decisions regarding their selection of an imaging facility for MRI, CT, or any other diagnostic imaging procedures.
Frequently Asked Questions
PriceMDs has a proprietary platform with an established database of facilities, surgeons and medical specialists throughout the U.S. that have listed all-inclusive bundled pricing for elective medical and surgical procedures.
It enables companies, public sector entities, and unions with self-insured healthcare plans to receive an all-inclusive, low-cost bundled prices for more than 400 outpatient elective surgical procedures at 30% – 50% savings.
A client pays a $4.00 per employee per month (PEPM) capitated rate. With 30% – 50% savings, one bundled surgery may cover the cost of the PEPM for 1 – 2 years.
PriceMDs’ national directory of doctors and facilities spans across 46 states with over 1,100-plus facilities, and 6,000-plus healthcare professionals.
PriceMDs SCC bundled pricing includes all costs that are required to perform that elective procedure. That includes the facility fee, the surgeon’s fee (inclusive of initial consult and post-op follow up visit and pre-op lab work), the anesthesiologist’s fee, also durable medical equipment sent home with the patient, implants & pathology if needed.
PriceMDs’ SCC program is a bolt on solution that can be added to a self-insured plan at any time.
Clients will be provided with marketing material to share with their members. This information will direct the member to contact a PriceMDs Registered Nurse (RN) if a physician has recommended surgery and their dedicated RN will assist the patient in choosing where to have their care. PriceMDs RN can also coordinate imaging if needed.
The patient is required to have a diagnosis and/or an initial plan of treatment from a physician and or specialist for an elective surgery/procedure. They must also be on the client’s medical plan.
A procedure that is deemed necessary for the patient but does not need to be performed immediately (i.e., colonoscopy, knee or shoulder replacement, ENT procedures, etc.).
The members’ out of pocket (OOP) cost is waived by the employer to encourage participation. They will also receive the guidance of an assigned PriceMDs RN to assist them through the process.
The patient preference can be accommodated if that provider is listed in PriceMDs’ directory. The ability to waive by the employer patient’s OOP cost (usually $2,000 to $5,000) is an incentive for the patient to choose the PriceMDs high quality and more cost-effective alternative solution.
Once a procedure is performed, the facility sends a UB04 claim for the authorized bundled price directly to the payor. The provider receives payment from the payor within 10 business days in receipt of the claim.
Contact PriceMDs at: +1 (813) 818-4531
