Posts Tagged TPA

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UPDATE: SubroShare® Focuses on Payers, Not Physicians

I received an email today from SubroShare® founder and CIO Stephen Ambrose, letting me know that SubroShare® has changed its marketing model from what he described in his recent interview here.

He describes the new model:

It was thought at one time that the health providers, by knowing about when a payer PURCHASED CRRs, could thereby use such information to effect reimbursement.  However, this has proven to not be applicable on an individual provider to payer basis – and actually a hindrance to interested payer clients.

Steve goes on to say that it is now clear that the two clients of SubroShare® will be payers and outsourced provider networks such as third-party administrators (TPAs), repricing agencies and preferred provider organizations (PPOs).  Physicians and care providers will not be marketed to as:

In fact, there are NO benefits to the Provider ”“ they are simply mandated to participate.  The information that is submitted by the Provider is known as ROI Data, and is simply an extension of the obligation they already have to provide the patient’s payer with TPL/COB information.

Coming soon to a contract near you: a clause requiring you to submit attorney requests for medical records to the payer.



Posted in: Medicare & Reimbursement

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