Creating A New Healthcare Economy – One Employer At A Time

Creating A New Healthcare Economy – One By One

A few months ago, Christina Barton (pictured) went on vacation in the Bahamas; a place she has vacationed for several years.  On this trip, she was accompanied by a friend.

One afternoon, as they were eating a late lunch, Christina fell down a few stairs at the resort, and fractured her arm and elbow.

Beyond her physical pain, Christina recalls feeling anxious and afraid of receiving health care outside the US.  However, she was taken to a private hospital there and received the emergency care she needed.

Upon returning home, Christina was advised she would need surgery to repair her fractures, including the placement of implants in her elbow.  As a member of High Plains Health Plan (HPHP), she reached out immediately to HPHP’s Navigation Concierge Team, and we sprang into action.

Within a day, the HPHP Concierge Team helped Christina get an appointment with an orthopedic surgeon, and shortly thereafter, she was scheduled for imaging and surgery.

Christina had a CT Scan done, and underwent surgery, all within a week of returning home.  Thanks to Christina’s choice to use a Tier One network facility, and a Tier One network surgeon, she paid $0 for her image and procedure – That’s right – $0 for her CT Scan, and $0 for her surgery.

You might be thinking, “Benefits like that would come at a very high cost”.  But the truth is, the employer’s plan paid 100% for Christina’s care while still saving tens of thousands of dollars on this surgery.

With Christina’s permission, we’re sharing her Explanation of Benefits (EOBs) to showcase what’s possible with High Plains Health Plan:

This first EOB covers the CT Scan (Procedure Code 73200).  When a plan pays just $430 for this test compared to the typical thousands of dollars, you can see how HPHP manages to waive Christina’s deductible, copay, and out of pocket expenses:

Here is the EOB that covers the Surgery Center where Christina had surgery.  Again, $0 Patient Responsibility, and look at the discount Christina’s employer received:

Finally, the “all in” price for facility, surgeon, anesthesia and implants that this HPHP client paid was $7,189.57 plus $430.00 for the image – $7,619.57.  Christina paid nothing.

Self-funded employers are happy to pay 100% for healthcare services, when they get exceptional deals, like this one.  Had Christina chosen to get services outside our Tier One network, it would have cost her $3,000 out of her pocket, and the employer’s plan would have paid upwards of $50,000 for facility, surgeon, anesthesia, and implants.

This is the entire mission of High Plains Health Plan.  Creating a new healthcare economy where employers and their employees can go for quality care at fair market prices. 

Now, personally, I would like to thank all the organizations that made Christina’s story possible, it’s not ALL High Plains Health Plan. The Surgery Center of Amarillo. Dr. Weinheimer, Tier One surgeon. Green Imaging, who we work with to access great imaging services at low prices. And Amarillo Strength & Balance, who provided Christina physical therapy, where she enjoyed a $0 copay for every session. We all work in collaboration through our Tier One network to deliver top-notch care at reasonable prices. They are amazing!

If you’re intrigued and interested in High Plains Health Plan, we encourage you to reach out and see what we’re building in our community.