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Setting Out-of-Network UCR Rates: Evaluating FAIR Health’s Benchmark Data and New Alternatives for Insurers and Employers
Webinar • Tuesday, January 10, 2012 • 1:00-2:30 Eastern time

Sponsored by Atlantic Information Services, Inc., publisher of
Health Plan Week, Inside Health Insurance Exchanges, AIS’s Health Reform Week and ACO Business News

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   Today, methods used to determine rates for out-of-network providers are coming under increased scrutiny. And rising deductibles and other out-of-pocket costs are leaving enrollees looking for tools that can help them estimate costs. Some medical societies have proposed that FAIR Health (and its 12 billion billed procedures for more than 120 million covered lives) become the default data source for determining rates for members who seek care from out-of-network providers. But some health insurers and self-insured employers have come up with alternative methods for determining Usual, Customary and Reasonable (UCR) rates for out-of-network providers.

Learn the pros and cons of various methodologies and which would be the best fit for your organization.

Learn more • Register today


As the revolution in rate transparency and out-of-network rate-setting unfolds, you need reliable answers to important questions about which methodology will work best for your organization.    

Join us on Jan. 10, 2012, as Robin Gelburd from FAIR Health and Robert Parke from Milliman give you all the specifics about FAIR Health and other alternatives being used today by employers and health plans to set out-of-network rates. You’ll hear directly from FAIR Health’s President and a leading actuary who specializes in provider contract review and benchmarking. You’ll get answers to these and other questions: 

  • What models exist today for setting out-of-network rates? What are the chief advantages and disadvantages of each?
  • How does FAIR Health’s new database differ from Ingenix databases? What’s new? What remains the same?
  • What are the pros and cons of basing out-of-network rates on a percentage of Medicare? How will FAIR Health’s Medicare comparison tool work?
  • How will detailed consumer pricing information about out-of-network costs encourage members to stay in network?
  • What are the chances that FAIR Health will become the industry standard? What must take place for this to happen?
  • How should benchmarking data be used to determine charges under value-based payment mechanisms such as an ACO?

Following the 60 minutes of expert presentations, a concluding 30-minute Q&A session will provide answers to your questions about the new UCR databases from FAIR Health and other alternatives for reimbursing out-of-network providers. Sign up today!

Sponsored by Atlantic Information Services, Inc., publisher of
 Health Plan Week, Inside Health Insurance Exchanges, AIS’s Health Reform Week and ACO Business News

Click here to find out about other upcoming AIS Webinars

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