* First and only plan to advocate for working uninsured/underinsured by
negotiating and contracting reduced fees with fully transparent pricing, on
members` behalf
* Innovative, value-driven model posts fee schedules online for providers and
patients
* Providers in rapidly growing network eager to have first structured,
cost-effective option for uninsured patients not eligible for government
assistance programs
NEW YORK--(Business Wire)--
The uninsured and underinsured have a new low-cost option for obtaining health
care services and prescriptions at significantly reduced prices, thanks to
Transparent Health Network, a unique non-insurance health care access plan
introduced today in the New York metropolitan area.
For a low monthly fee -- $39 for an individual; $54 for a family -- Transparent
Health Network members gain access to a rapidly growing provider roster that
includes primary care, specialist and ancillary health care providers who have
contracted to care for them at dramatically reduced fees. They also gain access
to extensive discounted pharmacy benefits, available exclusively at 400 Rite Aid
stores across the New York area. Transparent Health Network is not insurance, so
in return for the reduced fees, members pay the providers directly, at the time
they receive care.
"Transparent Health Network is, quite simply, a health care access model that
makes sense. More and more people have been losing their insurance coverage or
finding themselves unable to afford the premiums. Now, for the first time,
there`s a way for providers to help them," said Leon Smith, MD, past chairman of
Medicine, St. Michael`s Medical Center, Newark, NJ. "Unlike any plan I know of,
Transparent Health Network levels the playing field for these patients by
providing both fair prices and true transparency, so they can make educated
decisions about their care."
Health care services are one of the most important purchases an individual can
make, yet most people seek care blindly, without any idea how much it will cost,
how much their insurance companies will pay their providers, or how much they
will be reimbursed. Medical fees are rarely posted, and vary greatly from one
provider to the next for the same services. Further, one insurer might negotiate
many different fees for the same service with different providers. Typically,
uninsured patients are charged "usual and customary fees," which can be as much
as 42% to over 300% more than providers accept from Medicare. By serving as an
advocate for its members, Transparent Health Network uses the power of its
network to negotiate fees with participating providers and provides transparency
to members so they can make informed, value-driven choices about their health
care.
"Transparent Health Network was created on the premise that health care can and
should be affordable, even if health insurance is not," said Betty Heiman, CEO
and founder of Transparent Health Network. "It has always been appalling to me
that the most vulnerable patients, the uninsured-who lack the purchasing power
of a network- usually pay the most. Transparent Health Network is a
cost-effective solution for these people."
Transparent Health Network negotiates fees with providers in much the same way
as insurers do, but with two significant differences: With Transparent Health
Network, contracted rates are the same from one provider to the next within a
specified geographic area; and, for complete transparency, the contracted fee
schedules are posted online, at www.transparenthealthnetwork.com where members
and providers can access them easily. Members can look up the price of common
procedures before seeking care, so they can make educated decisions about when
and where to seek care, and maximize the value of their health care dollars.
With Transparent Health Network there are no exclusions based on medical history
or age, and memberships can be purchased or cancelled in one-month increments.
In addition, Transparent Health Network is a viable companion to high
deductible, or catastrophic, insurance plans.
Because Transparent Health Network is not insurance and members pay for care at
the time of service, Transparent Health Network also is expected to save money
for providers, by eliminating the cumbersome paperwork required by most
insurance plans. There are no claim forms, no referral or pre-authorization
requirements, no long waits for payment or denials, and therefore, no need for
lengthy appeals processes.
Transparent Health Network was designed to be an affordable option for
individuals who are working and either uninsured or underinsured and cannot
comfortably afford health insurance, but whose incomes exceed the maximum limit
for government assistance programs. According an analysis of the 2009 US Current
Population Study, there are more than 500,000 households in the New York
metropolitan area that have annual incomes of $60,000 or more, but are not
insured. Although not part of the analysis, it`s likely that many of these
households are uninsured by choice. In such cases, they are gambling that they
will not experience a catastrophic event and can afford to self-pay for whatever
care they need. Transparent Health Network refers to these people as the
"S-suite," for "Self-sufficient, Uninsured, Independent Thinkers and Employed."
"Transparent Health Network has found a novel approach to addressing the health
care needs of the population most often caught in the middle of the debate:
those who have a middle class income, too high to qualify for government
assistance but not quite high enough for them to comfortably pay for insurance."
said Wendell Potter, a consultant to Transparent Health Network and a former
insurance industry executive. "By creating an organization that empowers the
uninsured to receive care at fair prices they could never obtain on their own,
Transparent Health Network offers a sound, logical solution for its members.
While those who can afford the premiums should have insurance, Transparent
Health Network is an excellent, value-driven alternative for those who cannot."
About Transparent Health Network
Transparent Health Network is a product of Transparent Health Group, LLC, a
privately owned company committed to providing the uninsured access to
affordable health care at fair prices. Transparent Health Network is currently
available in the New York metropolitan region, including the five boroughs of
New York City, Westchester and Long Island. Its provider network currently
comprises more than 1,200 provider locations, including primary care, ancillary
care and a broad spectrum of specialties, and is growing daily.
In addition, Transparent Health Network membership includes access to pharmacy
benefits at 400 Rite Aid pharmacies throughout the New York metropolitan region,
including more than 500 prescriptions starting at $6.99/month. Beyond the
formulary, the plan includes discounts on additional prescriptions and a variety
of Rite Aid-brand front-of-store products.
Membership in Transparent Health Network is available through employers or
online registration through our website at www.transparenthealthnetwork.com.
While those who can afford the premiums should have insurance, and Transparent
Health Network can be combined with a high deductible health plan, membership
can also stand alone.
Because Transparent Health Network is not insurance, in exchange for reduced
fees members are responsible for paying providers directly when they receive
service.
For more information about Transparent Health Network, visit our website at
www.transparenthealthnetwork.com.
The "fine print"
Transparent Health Network is not insurance. For a low monthly fee, the Company
provides members with access to a network of health care providers who`ve agreed
to accept pre-negotiated, contracted rates for products and services. Members
are obligated to pay providers directly, at the time of service. Transparent
Health Network does not make any direct payments to providers for services to
our members, nor do we reimburse members for fees paid to providers.
Transparent Health Network
Wendy Mensch, 646-367-1750 ext. 109
wmensch@transparenthealthgroup.com
or
Corinth Marketing & Public Relations
Paul McDade, 212-255-5340
paul@corinthgroup.com
Copyright Business Wire 2009
