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Qualified Payment Amount

Rights and Protections Against Surprise Medical Bills for Emergency Services and Certain Services from Out-of-Network Providers at an In-Network Hospital or Ambulatory Surgical Center Plan participants are protected from surprise billing, also called balance billing,...

What Do Employees Think of Direct-to-Provider Healthcare?

Direct-to-provider healthcare is rapidly growing among employers seeking to lower their healthcare costs. But what do employees think of the idea? It turns out they like it quite a lot, especially when it comes to primary care. A nationwide 2021 survey conducted by...

The Northwell Direct / Brighton Health Plan Solutions Story

When Northwell Health, the second-largest employer in New York and the state’s largest health system, decided the rising cost of traditional health insurance was unsustainable, they decided the future lay with a direct-to-provider solution. By eliminating traditional...

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