Care coordinators handle the day-to-day of member navigation, help members understand what their plan covers, and find care within RBP allowed-amounts. This ensures care is medically necessary and priced fairly.
Approaches taken to find a cash pay price
Use public or internal directories (RBP calculator).
Assist members in requesting a Good Faith Estimate from providers.
Manually call providers directly to get cash prices.
Maintain a list of providers that accept cash pay in your region.
Required information to get to request a Cash Card
CPT code(s)
Date of service
Provider ZIP code
Typically, a Good Faith Estimate for any transactions >$5k
Make sure you are getting the full all-in price: Always ask if there's a credit card processing fee and adjust your request accordingly
(e.g., $100 charge + 3% = request $103 card).
Pro Tip: For Good Faith Estimates, Providers are required to provide one by law. This is especially useful when dealing with hospitals or large health systems who may delay giving a cash estimate