Three industry veterans with WellRithms,– a surgeon, a benefits broker, and a former health care manager — have pulled back the curtain on systematic billing abuses in the company’s latest e-book, “An Insider’s Guide to Medical Overbilling, and How to Protect Your Group Plan.”
“Our mission in publishing this e-book is to help shield more health plan sponsors from these outrageous practices by offering a unique blend of the market’s most advanced payment-integrity capabilities and medical expertise to best decipher egregious billing,” says Ira Weintraub, M.D., WellRithms’ Chief Medical Officer and one of the authors.
The publication exposes common abuses in hospital and physician billing that cost a typical union or employer health benefit plan millions of dollars every year. Moreover, 62% of the two million personal bankruptcies filed each year are the result of medical debt, according to the American Bankruptcy Institute.
The e-book details 10 case studies of egregious billing practices that turn common procedures into episodes costing more than $100,000 – offering guidance on how to fight back and pay only what’s fair. JAMA Open Network research estimates that medical pricing irregularities, fraud and abuse cost between $289 billion and $324 billion per year, or more than three times the entire budget of the state of Florida.
“In the realm of healthcare billing, it’s essential to distinguish between legitimate costs and those inflated beyond reason,” Dr. Weintraub continues. “Our team’s surgical experience is crucial in differentiating between genuine complexity and falsified complexity when we review bills line by line.”
Billing gimmicks that are usually overlooked by health insurers can quickly generate a mountain of overpayments by patients, unions, and employers. After reviewing and repricing bills, WellRithms typically finds savings of 70% or more while ensuring that providers still earn a fair profit.
“Just as the past decade created a need for protection from online data breaches, identity theft and ransomware, the prevalence of medical overbilling has paved the way for the unique medical bill review and repricing that WellRithms performs,” concludes Dr. Weintraub. “As this guide documents, WellRithms provides health plan sponsors a comprehensive, legally defensible protection that is second to none.”
About WellRithms
WellRithms is Leveling the Paying Field™ for purchasers and providers of health care committed to fairness in medical bill reimbursement. The company is recognized as the Master of Payment Integrity™, serving group health and workers’ compensation payors who rely upon its unparalleled technical, medical and legal expertise. WellRithms Shield Indemnification™ is backed by a captive insurance company, transferring all legal and financial liability from the payor to WellRithms. Visit https://www.wellrithms.com.
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