--- title: "Self-Funding Series: Hiring a Cost Containment Firm" description: Is your organization overpaying hospital bills or relying on the network to provide the best discounts? Hospital care accounts for about ... image: https://blog.nisbenefits.com/hubfs/blog-headers/blog-selffund-2of4-featured-1024x487.jpg --- ![Self-Funding Series: Hiring a Cost Containment Firm](https://blog.nisbenefits.com/hubfs/blog-headers/blog-selffund-2of4-featured-1024x487.jpg) # Self-Funding Series: Hiring a Cost Containment Firm - Home - [Employee Benefit News for School, City and County Employers](https://blog.nisbenefits.com) - Self-Funding Series: Hiring a Cost Containment Firm [ Erin Woulfe ](https://blog.nisbenefits.com/author/erin-woulfe) 11/15/2016 [ Health Insurance Solutions](https://blog.nisbenefits.com/topic/health-insurance-solutions) [0 Comments ](https://blog.nisbenefits.com/hiring-cost-containment-firm#postComment) 2 Minutes ## **4 Innovations that are Improving Self-Funded Health Plans** Article 2 of 4: Hire a Cost Containment Firm Self-funding is rapidly moving into schools, cities and counties of all sizes as a major cost-control strategy. And why not? Governmental organizations that self-insure can design their own plans and tailor them to meet their employee’s needs, all while eliminating those features with little utilization. All signs indicate that self-funding your plan can yield significant savings for stable groups from 30 employees and up. As adoption grows, cost-reduction strategies in self-funded environments are evolving as well. In this article series, Jason Rushton will share four top ways that your organization can take advantage of this trend. ### **![Hiring a Cost Containment Firm](https://blog.nisbenefits.com/hs-fs/hubfs/Imported_Blog_Media/blog-self-funding-2-of-4b-2.png?width=350&height=553&name=blog-self-funding-2-of-4b-2.png)** ### **Hire a Cost Containment Firm** Is your organization overpaying hospital bills or relying on the network to provide the best discounts? Hospital care accounts for about 40 percent of healthcare cost and at times 50-60 percent of the bill may be wrong, according to Mike Dendy of Phoenix-based [Advanced Medical Pricing Solutions (AMPS)](http://advancedpricing.com/). Dendy says his company can save an employer group “over 15 percent” by focusing on process errors on hospital bills. In order to stabilize premiums, healthcare spending must come down. Now, self-funded schools, cities and counties can turn to cost containment providers who sometimes even guarantee results or there’s no charge. How do they do it? Several ways. #### **Healthcare Concierge Service** This type of service helps employees find their way through the maze of healthcare. Once diagnosed, employees get help to find the best providers for non-emergency services by comparing provider outcomes and pricing. Additionally, the service may also contract with these providers and determine pricing prior to care delivery. #### **Reference-Based Reimbursement** Reference-Based Reimbursement is making payment determinations based on the fair market value – generally a percentage above the standard Medicare reimbursement. The claim limits are consistent with ERISA and DOL guidelines and negotiate a percent margin above the actual cost. #### **Medical Bill Review/Audit** It is estimated that over 80% of medical bills contain errors due to lack of physician review and other factors. Some services provide physician reviews line by line to ensure the bill is accurate and then negotiate with the provider to make adjustments. Negotiations can be backed by legal defense. #### **Out-of-Network Bill Reduction** While most of your organization’s healthcare spending is likely in-network, schools, cities and counties are finding that out-of -network claims can be very high. One way to keep these costs down is to use a service to apply the reference-based reimbursement program and then having the employee pay the difference between what was billed and what was paid. The service can help negotiate with the provider if they do not accept the proposed payment.   [Previous Self-Funding Article: Narrow Networks](https://blog.nisbenefits.com/self-funding-series-narrow-networks) [Next up: Managing Consumerism and Wellness](https://blog.nisbenefits.com/self-funding-series-managing-school-district-consumerism-and-wellness) --- #### Tag: [ Health Insurance Solutions](https://blog.nisbenefits.com/topic/health-insurance-solutions) #### Share: - [Follow us on Facebook ](http://www.facebook.com/share.php?u=https://blog.nisbenefits.com/hiring-cost-containment-firm) - [Follow us on Twitter ](https://twitter.com/intent/tweet?url=https://blog.nisbenefits.com/hiring-cost-containment-firm&text=Self-Funding%20Series:%20Hiring%20a%20Cost%20Containment%20Firm) - [Follow us on Linkedin ](http://www.linkedin.com/shareArticle?mini=true&url=https://blog.nisbenefits.com/hiring-cost-containment-firm) - [Follow us on Pinterest ](http://pinterest.com/pin/create/button/?url=https://blog.nisbenefits.com/hiring-cost-containment-firm&text=Self-Funding%20Series:%20Hiring%20a%20Cost%20Containment%20Firmdescription=4%20Innovations%20that%20are%20Improving%20Self-Funded%20Health%20Plans%20Article%202%20of%204:%20Hire%20a%20Cost%20Containment%20Firm&media=https://cdn2.hubspot.net/hubfs/3325505/blog-headers/blog-selffund-2of4-featured-1024x487.jpg) --- [ #### Using In-network Dentists Can Help Keep Health Insurance Costs Low ##### Previous Post ](https://blog.nisbenefits.com/using-in-network-dentists-can-help-keep-health-insurance-costs-low) [#### Final 2016 ACA Forms, Instructions, Good Faith Transition Relief ##### Next Post ](https://blog.nisbenefits.com/final-2016-aca-forms-and-instructions-released-by-irs) ### Leave a Reply This is a search field with an auto-suggest feature attached. - 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