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Provider Freedom True Freedom of Choice No Networks – No Penalties Who is Allied * Home Office - Overland Park, Ks. * 2nd generation business * Founded 1970 * Proprietary systems * Company culture Innovation Stability Service 2 Overview • Problems with PPOs • Provider Freedom is the solution • How Provider Freedom benefits you • How Provider Freedom works 3 What is a PPO Plan? Managed Care • First PPO network in mid 1980s - Early networks small local and regional health plans Grew to national networks as health plans grew and merged Provides discounts to retail health care costs • Percent discounts off retail • Per diem schedules • Fixed rate for service 4 Problems With PPO Plans Poor Discounts Limited provider choices • Which hospital? • Which doctor? Penalties, Penalties, Penalties • Out-of-network • Non-network providers within in-network hospitals • Out of area Multi-State Employers Tough to switch health plans 5 Provider Freedom is the Solution! True freedom of provider choice No networks Better than PPO discounts No penalties 6 A Proven Model Tested Nationwide Proven Discounts High Consumer Satisfaction 7 How Provider Freedom Benefits You Very popular with employers/ employees Reduces employer’s costs Easier to change health plans Eliminates network penalties 8 How Does Provider Freedom Work? Data ISight Payment Model Cost plus “fair and reasonable” discounts 9 Learning to use Provider Freedom We educate members when they get ID card We educate providers Members pay only normal copays, deductible and coinsurance No balance bill guaranty 10 No Balance Bill Guaranty “…covered person not responsible for any attempt by the medical provider to collect unpaid medical charges…” Excludes Deductibles, copays, coinsurance Medical care not covered by plan Improperly filed claim Late claim filing Call Allied National Customer Service for balance bill issues: 800-825-7531 11 Provider Freedom Provider Claim Payment Acceptance 92.0% - Accepted as paid 4.0% - Call and accept 3.5% - Adjust and accept 0.4% - Adjust to retail 0.1% - Balance bill 12 Provider Freedom Your initial provider appointment using Provider Freedom: Present your ID card Majority of providers currently accept the card Allied pays claims to over 250,000 providers If your provider is uncertain about the Provider Freedom plan, call Allied Customer Service: 800-825-7531 13 Provider Freedom Available with Funding Advantage in these states: California, Georgia, Iowa, Illinois, Indiana, Kansas, Missouri, Nebraska, Nevada, Ohio, Oklahoma, South Carolina, Tennessee, Texas 14 Allied™ Provider Freedom How Provider Freedom benefits you 20 We’ll be happy to answer your questions now. Questions? Need More Information? Allied Customer Service: 800-825-7531 Allied National www.alliednational.com 4551 W. 107th St., Suite 100 Overland Park, KS 66207-4037 11221s1213