Cash Pay at Yuzu

This guide, designed for Care Navigators, explains the basics of Cash Pay at Yuzu and our Cash Pay Cards. Cash Pay Cards allow members to pay providers from their health plan for services using a digital credit card, at no cost to them.

  • Comparing Costs to RBP

    • RBP Calculator

  • Determining Fair Pricing

    • Resources and methodologies to use

  • Creating cards

    • Decision tree for deciding what type of card to request

    • Good faith estimate required for claims >$5K

    • Details required for a card

    • Member notifications upon swipe

    • Managing cards for dependents

    • PO boxes as addresses inhibiting card requests

  • Cash Pay Flow Guide

    • Expected behavior for cash cards once created - including auto-closing and expiration dates

  • Prior authorization (Cash pay process for claims >$10K)

    • Traditional prior authorization

    • Cash pay process

    • Pre-certification threshold (>$10K)

    • Information needed for a pre-certification

    • Submitting pre-certification information to Yuzu

    • Timeline (~ 1 week typically)

  • Providing members cards

    • Notifying members

    • Responding to a voided transactions

  • Receipt policies

    • Overview

    • Documentation needed based on card and transaction size

      • DPC Lab Cards

      • Swipes <= $500

      • Swipes > $500

      • Reimbursements

    • Enforcement mechanisms

  • Managing receipts

    • How member receipt uploads works

    • How to upload receipts as a care coordinator

    • Remind members via email or text to upload receipts

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