Why pay retail?
If you're one of the 47 million Americans who either don't have, or don't have enough, health insurance, you're probably overpaying for health care - if you're receiving care at all. That's because when you walk into a provider's office without the safety net of an insurance policy or government assistance program, you pay full retail prices - sometimes known as "usual and customary" fees.
At Transparent Health Group, we don't see the sense in that.
Years ago, "usual and customary" referred to whatever fee was the "going rate" in the marketplace. Insurance companies offered coverage based on a percentage of that rate. Today, Medicare, insurers and many discount card companies use "usual and customary" fees as a baseline for negotiating reduced fees in contracts with network providers.
Here's the catch: Today, ONLY those who can least afford them pay so-called "usual and customary" fees: the people who don't have insurance and don't qualify for Medicare or other assistance programs. In fact, "usual and customary" fees are usually two to three times higher than those paid by big for-profit insurance companies and even Medicare. So, if you don't have the safety net of insurance, you're probably paying full price for health care, while "the big guys" are getting significant discounts.
Further, since "usual and customary" fees are rarely, if ever, made public, the uninsured have no way of knowing in advance what the cost of care will be. Often, they're in the awkward position of negotiating for discounts from providers during an office visit. Even programs that advertise a broad range of discounts on medical fees don't reveal the cost basis for the discount, so it's impossible to tell if there really is a significant savings. Where is the transparency in this complicated, cumbersome system?
About Transparent Health Group
Transparent Health Group was founded by a team of entrepreneurs who believe that everyone -- regardless of employment status, age or medical history -- should have access to health care at fair, affordable prices -- with no surprises.
To help balance the scales, we created Transparent Health Network by building our own robust network of providers. Those in our network share our commitment to serving uninsured and underinsured consumers with open access to quality care at fair, affordable prices. That's why they agree to care for our members at fees equal to 100% of those on the fee schedule for their locality from - you guessed it - the big guy: Medicare.
And, unlike our competitors, we didn't just "buy" a prepackaged network of providers, who then don't even know they're part of the plan. We took the high road to ensure that we'd have the highest quality network possible, enlisting the support and membership of individual providers and practices. That means our members get access to qualified providers who are as committed as we are to offering care at fair prices. It also puts health care decision-making back where it belongs: in the hands of caring providers, who can discuss treatment options with their patients without concerns about pre-authorization, referrals or denials from a disinterested third party.
Importantly, Transparent Health Network is not insurance. Our members are responsible for paying providers directly when they receive service, unless other arrangements are made with the provider in advance. Direct payment keeps costs down by eliminating the need for cumbersome claims processes, payment delays, denials, pre-authorizations and referrals. In addition, Transparent Health Network features online access to our clear, easy-to-understand fee schedule for the most common services, so there are no awkward negotiations in the providers' office.
Whether as a companion to high-deductible health insurance or an affordable alternative, Transparent Health Network clearly offers access to care at prices that won't make you sick.