A clearer payment arrangement
A participating agreement establishes the care it covers and the terms of payment. For a confirmed eligible $0 episode, the plan pays the agreed amount and the member has no share of that bill.
Removing the member’s payment responsibility from that episode can reduce the need to collect from the patient. The facility evaluates the overall agreement, including its services, prices, and payment terms.
A reason for members to consider the facility
When eligible care costs the member $0, the facility becomes an option worth understanding. Employers and advisors can introduce that option as part of the health plan.
People still consider the care they need, their clinicians, trust, and practical access. Participation creates an opportunity; it is not a promise of patient volume.
A relationship that continues
Rubicon adds and onboards facilities and manages the ongoing facility relationship. The TPA has a separate role in plan administration, claims, and care navigation.
A partnership conversation establishes the responsibilities and arrangements that apply to that facility. Payment deadlines and other commitments belong in the individual agreement.
Where to begin
Talk with Rubicon about the services and locations your facility would like to discuss.
Explore facility participation