What You Don't Know Can Cost You
SurgeryShopper.com helps group health purchasers and plan administrators lower claim spend.
Save $15,000 per case or more for many procedures we list
Offer plans with lower deductibles
Reduce reinsurance expenses
Raise beneficiary satisfaction
Surgery Shopper.com helps our clients to save money on surgery expenses through:
Excellent board certified surgeons and anesthesiologists, accredited inpatient and outpatient surgical facilities
Transparent, bundled surgery pricing for consumers and group health purchasers
Concierge Care Coordination and travel support before, during and after surgery
Predictability in future surgical claims costs
The list of the procedures contained on SurgeryShopper.com are only a partial listing of the most popular procedures that can be performed by the providers in our network. Please call for clarification and to verify inclusions and exclusions. (800) 209.7263
Bundled pricing generally includes the following:
- the initial surgical consultation
- pre-admission care continuity conference, if indicated
- facility fee
- anesthesia fee
- surgeon fee
- discharge management visit
- hand off care continuity conference, if indicated
- hardware, implants and prosthetic
Quotes generally exclude:
- any lab, EKG, x-rays, biopsy, MRI, etc.
- additional consultations to determine/assess the medical risk of surgery
- physical therapy or rehabilitation
- expenses or fees associated with or resulting from complications both subsequent to the completion of the procedure/surgery and discharge from the facility
- any lodging and travel expenses
- follow up office consultations and aftercare (x-rays, supplies, etc.) post discharge from the facility
We work with the following groups:
Taft Hartley & Union Plans
Municipalities, County and State Government
School Boards, Universities and Colleges
Multiple Employer Welfare Arrangements (MEWAs)
Farm Bureaus / Credit Unions
Health Sharing Ministries
TPAs & Benefits Consultants
Reinsurers and Health Insurance Captives
Attend a Workshop with Maria Todd!
August 27, 2019 | St George, UT
Realize hard dollar savings on surgery before October 1 when the deductible satisfied surgery rush begins.
- Learn how to set up a local or medical travel surgery savings program.
- Learn how to contract directly with providers, while being mindful of your fiduciary duties under ERISA and IRC213D.
- Build in incentives that enhance plan beneficiary satisfaction and drive utilization towards your highest-value providers organically.
- Put an end to PEPM network access fees! You only need to shortlist a few providers with the surgery bundles you need for your unique plan population.
- You won’t need to pay someone to negotiate reference-based prices if you have a transparent, value-based contract with great bundled surgery rates.
- Create your own bespoke national narrow network. It’s easy when you know how and you have all the contract templates in hand, which you’ll receive in class in a bonus package.
SurgeryShopper.com has arranged a 50% discount with code “CONTAIN19”
for Brokers & Consultants
We welcome the participation of Brokers and Consultants in utilizing the cost containment strategies of SurgeryShopper.com.
Your clients look to you for your advice and expertise to help them discover cost containment solutions to save their health claim dollars.
We invite you to share our service model and bring a value added feature to your clients’ healthplan. Keep in mind that we don’t charge them a network access fee to access our providers. We work with any size group. Our providers offer their deepest discounts in exchange for easy compliance with their unique programs. In most instances, the bundled case rates are better than rates offered by their ASO, TPA, or other managed care organizations.
For your convenience, we offer additional information and client-facing materials available by request, including power point presentations, brochures, and sample payer contract agreements. Arrange a presentation for your clients with members of our senior team by contacting our Client Concierge Desk at (800) 209 7263 for details. We value your support of SurgeryShopper.com.
to our Free Group Health Newsletter
We publish a monthly newsletter that features information about new providers, procedures, prices and locations featured on SurgeryShopper.com and innovative cost containment solutions to save health claim dollars.
How to conserve plan trust dollars and get more value from what you pay
Analyze What You've Paid in the Past
Predict What You May Need Going Forward
- Ask for help. Many benefits consultants will help you analyze past claims data to determine if you have any high-cost surgery exposures that could benefit from a “trim”. It’s beneficial to find a competent professional without conflicts who will simply analyze your claims data without fear that finding savings means lower kickbacks and trips to Hawaii. Call SurgeryShopper.com for some referrals of independent analysts we know and trust.
- Expect resistance. Chances are high that you’ll encounter resistance when you ask for your claims data. Your TPA or broker will want to know why you want it, what they can help you find, that having claims data risks HIPAA violations, and more. All that is essentially “hogwash”.
- Don’t accept excuses. Demand delivery of your requested de-identified data by a certain date. The more resistance you face, the higher the likelihood that there’s concern you’ll find something. It is not their business why, or who will review the data that they supply. Ask for data from the last three years. That way, you can spot trends. After all … it’s your data.
- Make no assumptions. Don’t assume the problem lies only with TPAs, commissions, and double- and triple-dipper kickbacks and trips to exotic destinations. Many times the effect is caused by collusive acts against consumers by hospitals, health systems, physician-hospital networks, and sole supplier medical and surgical groups.
- Apples to apples comparisons. You must have total value-based transparency and comparative prices for same procedure bundles along with clinical outcomes to demonstrate high performance at a lower cost.
- Don’t dismiss savings opportunities on lower-cost/higher-volume procedures. Some employers with plan participants in a different age range may find savings in reducing the number of ENT (tonsillectomies, sinus surgery, etc.) general surgery (hernias and gallbladders), gynecology (tubals, endometriosis, and hysterectomies), and urology (obstructed kidney stones, vasectomies, newborns with epispadias, circumcisions, etc.) and sports injuries, fracture care and concussion treatments. Others, with older workforces may find savings in big ticket orthopaedics, neurosurgery, cancer treatments, and cardiovascular procedures.
Use Data From SurgeryShopper.com to Pay Less
Without Resorting to "Reference-based" Pricing
Negotiated transparency will always cost less than the amounts you (and your plan participants) may pay with unpredictable reference-based pricing (RBP).
- Insufficiency. One reason is that the reference-bases could be wrong. The amount you chose to offer may be way off base and insufficient. That can happen easily if you acquire data from past claims paid or from data sources like Healthcare Blue Book and Guroo, as their data is based on the old way of purchasing and paying for healthcare, with all the “onion-layers” highlighted in the infographic shown above.
- Refusal. Another is that many providers will tell you to take your reference-based offer and hit the bricks. This is especially true if someone approaches them with RBP after the procedure as a surprise instead of in advance.
- Inequity. If you ask for a provider to accept RBP, without a contract, there’s no incentive for them to agree to the rate or to agree not to balance bill. For one thing, they don’t know if you’ll ever be back to buy more from them. As a one-off, where’s the equity?
There's no cost to a group health purchaser to use SurgeryShopper.com to find lower prices
The providers listed in our database and the bundled price surgeries they’ve offered through SurgeryShopper.com are yours for the asking. Each of the facilities, board-certified surgeons and anesthesiologists have passed our vetting and inspection processes and met or exceed our rigid standards.
Now, your company can access this information through SurgeryShopper.com at no cost to you. Strengthen your employee benefits package by expanding your employees’ access to SurgeryShopper.com’s surgery marketplace for access to pre-qualified, accredited hospitals and ambulatory surgery centers throughout the USA. Every one of the facilities and surgeons in our database are eager to prove their value, quality and service in a pilot program to help you stem the cost of high-dollar and high-frequency surgeries while improving the health and wellness of your employees and dependent plan participants.
Join hundreds of self-insured employers and their TPAs who have extended access to bundled price surgery and surgery travel benefits at no cost to their employees. Achieve hard-dollar savings on joint replacements, cancer surgeries, hernia repairs, tonsillectomies, gynecology, urology, spine surgery, heart surgery, interventional pain management, ear nose and throat surgeries and more while reducing surgical complications, post-operative infections and readmission rates.
SurgeryShopper.com alos provides members who utilize our participating network health facilities with a dedicated care coordinator. The care coordinator manages all aspects of the surgery from records collection and surgery preparation through travel planning and recovery. To incent utilization, many companies waive employee deductibles and co-insurance associated with the surgery and cover any related travel and lodging expenses for the member and a travel companion.
The bundled rates you discover on SurgeryShopper.com allow self-insured group health plans to improve the surgery quality and outcomes while reducing costs from 30% to 50% on average, per procedure. Your plan members are supported through SurgeryShopper.com’s concierge-level care and travel coordination, eliminating the stress of planning and preparing for surgery. Simple. Efficient. Transparent.