Reference Based Pricing Support & Advocacy

Effective integration with Utilization Review allows MedWatch to provide the approximate dollar amount payable, and/or the reimbursement model utilized to determine payment, to providers at the time of pre-certification. This pre-service/pre-admission notification greatly diminishing disputes and balance billing. If there are questions by the provider, MedWatch provides information based on the members Benefit Plan design and works to establish a viable agreement.

MedWatch's Reference Based Pricing & Value Based Payment reimbursement models vary by client and require various levels of support to be effective. Be it facility only or a full network replacement, MedWatch provides four specific levels of support designed to enhance the front and back end process surrounding each of our RBP/VBP models.

When combined with the Pathways Member Concierge Services, MedWatch provides a comprehensive member focused “single point of contact” program that captures the high volume of member and/or provider calls to answer their questions regarding benefit plans, claims and balance billing, steerage to high quality healthcare providers/facilities, medical/surgical procedures, prescriptions and more.

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