What is Transparent Health Network?
Transparent Health Network provides revolutionary access to affordable health care for uninsured employees. Our members generally save 40-80% on physician's services at over 3,000 provider locations, including primary care, specialists, radiology centers and labs. Our partnerships with national networks provide members with 15-40% savings on dental and pharmacy too. We offer revolutionary price transparency - members can look up prices before getting care. Members pay providers directly at time of service. Anyone can join - no exclusions. It's easy and affordable to join Transparent Health Network- our low monthly membership fee is only $39/individual and $54/household. Transparent Health Network is not insurance, it's access to affordable health care.
Transparent Health Network is available in the New York Metropolitan area, including the five boroughs, Westchester, Long Island, Rockland & Orange counties. Transparent Health Network is in New Jersey, including Essex, Bergen, Hudson, Passaic, Union, & Middlesex counties. Transparent Health is expanding into Dutchess County, NJ and the metropolitan Atlanta,GA area in Fall 2010.
Who can join Transparent Health Network?
Anyone can join Transparent Health Network. There are no limitations or exclusions based on medical history, age or employment status.
What are the benefits of membership?
There are many benefits to joining Transparent Health Network. Among them:
- Affordable monthly membership fees ($39/ individual; $54/household)
- Deeply reduced fees for health care: 40-80% below "retail," or "usual and customary" fees on medical services and 20-40% on dental.
- Comprehensive provider network including primary care, 70+ specialties, labs, radiology services and dental.
- Discounts of on prescriptions at Rite Aid, including over 500 brand-name and generic drugs @ $6.99/month, up to 20% discount on brand name and other generic drugs, plus a 20% discount on Rite Aid branded products
- 24-Hour Nurse Hotline
- An on-staff Hospital Advocate who helps members get the lowest applicable rates for hospital and emergency room care
- The power of knowledge: Pricing for common procedures posted online at www.transparenthealthnetwork.com or available by calling (877) 571-8950
What is the basis for the Transparent Health Network fee schedules?
Transparent Health Network negotiates reduced fees for the uninsured and under-insured in much the same way many insurance companies negotiate their allowable fees. Our regional fee schedules vary by location. These fees can be as much as 40-80% lower than the "retail" prices typically charged to the uninsured.
Where is Transparent Health Network available?
Transparent Health Network is available in the New York Metropolitan area, including the five boroughs, Westchester, Long Island, and Orange county, and in New Jersey, including Essex, Bergen, Hudson, Passaic, Union, & Middlesex counties. Transparent Health is expanding into the metropolitan Atlanta area in Georgia.
How is Transparent Health Network different from other low-cost health care plans?
Transparent Health Network members can feel confident that they're paying fair prices every time they seek care. To our knowledge, we are the only health care access plan offering transparent regional fee schedules based on the 2009/2010 Medicare Fee Schedule, which are posted online where providers and members can find them at any time. Many other low-cost plans claim large fee reductions, but never provide the basis for those reductions, or post the actual fees online, so it's impossible for members to know whether or not they are getting a good value. With Transparent Health Network, the costs are transparent. Visit our website and click "How Much Will This Cost?" to see fees for common procedures in your area.
Additionally, Transparent Health Network is committed to offering a home grown provider roster and the highest quality customer service possible. That's why, unlike many other low-cost health care plans, we didn't just "buy" a pre-packaged network, whose providers don't even know they're part of the plan. Instead, we built an exclusive network of providers who share our commitment to making affordable health care available to every patient, insured or uninsured. The Provider Directory is available on all home pages of our website at www.transparenthealthnetwork.com. Members can see any provider they choose, at any time, with the knowledge that the plan will be recognized and accepted by all providers listed.
Is Transparent Health Network insurance?
Transparent Health Network is NOT insurance. It is access to affordable health care. Transparent Health Network offers members access to medical services at prices that are generally 40-80% below "retail." In exchange for reduced fees, members pay providers directly, at the time of service. Transparent Health Network does not get involved with, or take responsibility for, billing, claims or reimbursement.
How many providers participate in Transparent Health Network?
The Transparent Health provider network is growing every day. There are currently over 3,000 participating provider locations in the New York / New Jersey Metropolitan area. To see a list of primary care providers and specialists in your area, visit our website.
Will providers recognize Transparent Health Network when the membership card is presented?
Yes. To create the highest quality provider network possible, Transparent Health Network built its own, exclusive roster of providers who share our commitment to giving the working uninsured and underinsured a way to obtain health care services at affordable fees.
What hospitals services does Transparent Health Network include?
Transparent Health Network offers a Hospital Advocate service, which helps members obtain the lowest applicable rates for hospital and emergency room services. Transparent Health Network is not affiliated with any hospital. Because Transparent Health Network is not insurance, members are required to pay hospitals and staff directly for all services.
How do members pay their providers?
In exchange for reduced fees, members must agree to pay their providers directly, in full, on a fee-for-service basis, when they receive care. The fees for most common procedures are available through our online cost estimator, so members have a good idea how much their visit will cost before seeking care. This knowledge empowers our members to make educated decisions about the value of the services they seek.
Is there a co-pay?
No. Transparent Health Network is not insurance, so there are no co-payments, coinsurance or deductibles. In exchange for reduced fees, members are required to pay providers directly, in full, on a fee-for-service basis, when they receive care. The fees for most common procedure fees can be viewed on our website at www.transparenthealthnetwork.com, or members can call (877) 571-8950.
How many times can Transparent Health Network members see their providers?
With Transparent Health Network, there are no limitations on the number of times members access care or pharmacy benefits. It's not insurance, so all treatment decisions are in the hands of the provider and the patient. There are no claims, no pre-authorization or referral requirements, and no denials.
What if a member wants to see an out-of-network provider?
We cannot take responsibility for fees charged by out-of-network providers. Members are welcome and encouraged to invite their providers to join our network by visiting our website, or can give the provider's name and contact information to us by calling Provider Relations at (877) 297-8864, and we'll invite them to join. In the interim, to obtain care at the rates listed in our fee schedule, members should use our provider map to locate alternate providers.
Who is included in the Household Plan?
The Household plan includes members who reside at the same address. Each household will receive up to two Transparent Health Network membership cards printed with the names of all active household members.
How do members use their Transparent Health Network membership for discounts on prescriptions?
Members must present their Transparent Health Network membership cards to a Rite Aid pharmacist with their prescriptions to receive the appropriate discounts on medication. In addition, members can present their card at the cash register to get 20% off other Rite-Aid brand products.
How are monthly membership fees paid?
Members can pay their monthly fees in either of two ways:
- as a payroll deduction through their employer, or
- directly to Transparent Health Network by Credit Card, Check or Money Order
What is the cancellation policy?
Transparent Health Network Members can cancel at any time with no cancellation fee. Members enrolled by their employers should notify the employer. If you enrolled directly with Transparent Health Network, you can cancel by notifying us in writing either by email to helpdesk@transparenthealthgroup.com or U.S. Mail addressed to: Transparent Health Group, 434 E. Baltimore Pike, Media, PA 10963. Members who cancel within 30 days of enrollment will receive a full refund of their membership fees. Please note that application fees, if any, are non-refundable.
Can an employer offer Transparent Health Network without offering health insurance?
Yes. Transparent Health Network is not insurance and is a stand-alone product.
Can members/employees opt-in and out of Transparent Health Network?
Yes. New employees can be easily added to Transparent Health Network at any time. Employers should contact Customer Service at 877-571-8950 to add new employees.
Employers can notify Transparent Health regarding Employees who are leaving the company by emailing helpdesk@transparenthealthgroup.com or call Customer Service at 877-571-8950.
Can employers offer Transparent Health Network membership as a pretax benefit?
Employers are responsible for Section 125 administration. We suggest they consult with their accountants or legal advisors regarding tax questions.
Can part-time employees, 1099's and/or non-citizens participate in Transparent Health Network?
Anyone can join Transparent Health Network. There are no limitations or exclusions based on medical history, age or employment status. Transparent Health Network is not insurance, but is an excellent, affordable option for part-timers, 1099's and/or non-citizens who either can't afford or don't have access to health insurance.
Are there participation requirements? How many employees have to join?
There are no participation requirements for Transparent Health Network.
How do I sign-up my employees with Transparent Health Network?
Transparent Health Network is sold both direct and through Insurance Brokers. Contact your insurance broker for more information or visit the Employer section or call Transparent Health Network directly at (877) 571-8950 or visit our website www.transparenthealthnetwork.com/employers