 The Agencies Break Silence on the Hobby Lobby SCOTUS Ruling
The Departments of Labor, Health and Human Services and Treasury (the agencies) have issued a joint FAQ about the recent ruling from the Supreme Court of the United States (SCOTUS). The ruling provides that certain companies with group health plans that are currently providing preventive contraceptive services may now cease to offer coverage for all or any contraceptive service. The FAQ addresses how this affects required plan documentation for companies intending to make a change. Learn more...
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Argus Advantage Series:
Argus Claim Review - a division of Cypress Benefit Administrators - guards against costly healthcare billing errors, issues with medical claims processing and other claim system deficiencies. Learn more about how this industry-leading system works via this series of occasional articles.
Provider Pricing and Reimbursement Methodology
In an age of skyrocketing health care costs, Argus believes that a self-insured employer should never have to pay more than what is appropriate for the level of service provided. Since hospitals, physicians and other providers of health care independently set their own pricing, charges for like services can vary broadly from one provider to the next.
Since part of what Argus does is to determine whether or not billed fees are appropriate or not, you may be wondering upon what basis Argus makes these determinations. In this Argus Advantage Series article, we provide you with an analysis of two actual files for two patients who both had the same condition, at the same time and received virtually identical treatment. This analysis not only demonstrates the wide variation in pricing that occurs, but also explains how Argus determines an appropriate level of payment - and ultimately also highlights the savings Argus reviews often yield. Read more... <back to top>
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