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Case Studies:
Sample Case A – A member living in Arizona went to the emergency room of a participating hospital and was diagnosed with appendicitis. The member received an emergency appendectomy and was in the hospital for two days. Charges submitted to a savings plan case manager included claims from the hospital, as well as the ER physician, surgeon, anesthesiologist, and pathologist.
Total Charges: $16,157
Total Savings: $6,775
Total Saved: 41.9%
Sample Case B – A Member in Texas was pregnant and called her savings plan case manager to make arrangements for the delivery. After determining the potential savings for the Member, certified funds were deposited, and a referral was sent out to the hospital. The Member delivered a beautiful baby girl.
Total Charges: $4,532
Total Savings: $1,781
Total Saved: 39.3%
Sample Case C – A member in New Jersey was in need of preventative surgery. While the Member’s selected surgeon was not a participating provider, the hospital was, and his Case Manager worked with the surgeon’s office to find a participating lab and anesthesiologist recommended by the surgeon.
Total Charges: $10,623
Total Savings: $3,853
Total Saved: 36.3%
* Hospital Discounts NOT available in Maryland and West Virginia
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