REFERENCE BASED PRICING
Contain costs without sacrificing satisfaction.
Control medical expenses and enhance employee happiness with care navigation.
We know
what works.
The cost of medical care often goes unchecked and there’s no consistency between doctors, hospitals, or procedures. And when pricing varies so greatly, it’s difficult to plan for future medical expenses. That’s why many employers are turning to Referenced Based Pricing.
With greater transparency and control, employers see lower costs. But the biggest challenge is helping employees navigate their benefits and their network. That’s where we come in.
Referrals to the most effective care.
By matching members to appropriate providers and services, they get the right care at the right time.
When combined with Reference Based Pricing, care navigation drives better quality and cost containment by helping members make the RIGHT decisions about their healthcare.
Members are proactively steered by trusted Care Advocates to high-value providers that will best meet their needs, reducing the anxiety around changing health plans and “choosing the right doctor.”
Maximize your RBP plan.
Member experience is a top priority.
Before a Reference Based Pricing plan goes into effect, we review existing providers and scheduled appointments to make sure each member is matched with the best in-network provider. If not, we refer them to a more suitable provider.
Reference Based Pricing Plan Services
Care Concierge
Care Advocates help members find the best doctors within your Reference Based Pricing plan, offering expert guidance in how to use their plan wisely.
Members are also assisted with getting a second opinion and alternative treatment options.
Precertification
To determine medical necessity, our clinical team evaluates inpatient admissions, diagnostic testing, outpatient services, chemotherapy, durable medical equipment, and more.
Using national guidelines for medical review, we ensure members get the most appropriate care.
Case Management
Our Case Management team helps members with complex medical conditions, hospitalizations, unhealthy lifestyles, and more.
They review treatment plans and coordinate care between providers, getting involved before key decisions are made and costs incurred.
Virtual Care
For high-quality care beyond a doctor’s office, members can access our highly experienced team of virtual care providers.
We help members feel their best through health and wellbeing coaching, physical therapy, chronic condition support, and mental health therapy.
SentryHealth has been the gateway to lower healthcare costs the last three years. Our results speak for themselves, each year benefits have gotten richer, and costs have gone down.
– Laurie M., Benefits Consultant
