The right reimbursement for billed services.
MedBen Fair Market Reimbursement (FMR) saves big by leaving nothing to chance. We compare your plan members’ claims against national market data – network and non-network claims, Medicare and Medicaid, hospital reimbursements, and even cash payment rates – to determine the right reimbursement for billed services. You’ll see the difference in your bottom line.
HOW FMR SAVES
National Claims Data
MedBen gathers annualized market data from millions of claims processed across the country.
Targeted Benchmarks
We incorporate geographic and provider-specific benchmarks to deliver proper provider fees.
Professional Reviews
Every claim is reviewed by medical professionals to ensure no savings are left on the table.
Fast Facts
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Overall, MedBen FMR yields a discount average of 71% per claim.
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The average provider appeal rate is only 0.35%.
The FMR Process
Every step in the MedBen FMR process, from claims review to provider reimbursement and client reporting, is designed to ensure payment accuracy and total transparency. Plus, our pricing engine seamlessly integrates with other components of your plan, so you won’t experience any turnaround delays.
Proven Results
Since 2021, MedBen FMR yielded a discount average of 69%. In 2023 alone, the average savings rate was 71%.
Additionally, with FMR, even the smaller savings are big. No matter the service type, our reimbursement analysis methodology will greatly reduce your health care spend.
Payments Supported
On the rare occasion a provider questions a payment, our reimbursement recommendations can be readily defended, and negotiations will be conducted when appropriate. The average appeals rate in 2023 was only 0.35%, with a 100% resolution rate… and in every case, settled for the original reimbursement amount.
Put FMR to the Test
Send MedBen a mix of test claims – inpatient, outpatient, physician, or any other services – and we’ll provide a comparison of FMR rates against your current claim costs so you can see for yourself how much you can save.
Unmatched Savings
No other claims pricing method compares to FMR. Consistent cost reductions, fair payment policies, and defensible reimbursements… together, it adds up to maximum savings with minimum noise. Contact your broker or call MedBen at (888) 627-8683 to learn more.
Self-funding Saves. MedBen Delivers.
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Benchmarking
MedBen Analytics' benchmarking capabilities enable you to compare your data against state and national norms and/or specific industries. You can narrow your benchmarks by plan type, number of lives and other metrics to get a true measure of how your plan stacks up.
Your benchmarking choice is immediately reflected on the dashboard content.
Straight RBP
Providers receive fair reimbursement by using Medicare pricing as the primary source of repricing. And because your plan no longer has a PPO, your plan members can go anywhere they choose for medical care.
Pharmacy Cost Plus Pricing
RBP for your prescription drugs.
Layered RBP
Target high-cost medical treatments, such as kidney dialysis.
An Extensive Reporting Library
Once you've chosen your population, reporting period and benchmark preferences, just sit back and watch MedBen Analytics go to work for you. Dozens of charts, graphs and tables, instantly generated. Our financial, clinical, risk and savings reports show you what is working with your plan while highlighting areas of potential improvement.
FSA Store is the largest online marketplace for guaranteed FSA-eligible products, helping flexible spending account holders manage and use their FSAs and save on more than 4,000 health items using tax-free money. You can pay for purchases using your MedBen FSA debit card so they are automatically noted on your account balance.
Use these convenient links for finding FSA-eligible products and calculating your FSA tax savings. FSA members can check their current account balances by visiting MedBen Access or downloading our mobile app from the Apple App Store or Google Play (search for "MedBen").
Use this secure 24/7 service portal to access claims and benefits information. MedBen Access enables you to:
- Check claims status
- Review benefit coverages
- Download explanations of benefits (EOBs)
- See deductibles, out-of-pocket costs and calendar maximums
- Look up drug information, compare local pharmacy prices and check availability of lower-cost equivalents
- Review FSA and HRA activity and balances
- Check wellness exam and screenings compliance (for WellLiving members)
If you need assistance logging in to MedBen Access or using its features, please contact MedBen Customer Service at 800-686-8425.
MedBen Access is also available as a mobile app with the same great features! Download it from the Apple App Store or Google Play (search for "MedBen").
Download the MedBen Client Report
Please register to download the Client Report. Thanks!
Frequently Asked Questions about using the debit card (PDF).
Download a list of participating pharmacies, discount stores and supermarkets that can identify FSA-eligible items at checkout using an Inventory Information Approval System (IIAS).
Download a list of participating pharmacies, discount stores and supermarkets that do not use IIAS, but 90% of whose sales come from medical care items (thus making them FSA-eligible).
Medical Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Pharmacy Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Medical Solutions.
MedBen will work with your clients to find the best solution to meet specific employee population needs. Increasingly, organizations are going outside the PPO box and turning to direct-to-employer contracting, reference-based pricing, and other alternative reimbursement strategies with set pricing that makes it easier to predict expenses. And their members can visit the doctors they prefer and still realize lower out-of-pocket costs.
Pharmacy Solutions.
MedBen Rx follows a simple philosophy: The client's money belongs to the client. Our pharmacy solutions are designed to get members the right drug at the lowest cost, with total transparency to the employer. These include:
- Pricing solutions that ensure clients pay just what the pharmacies pay.
- Appropriateness solutions to find the most effective drugs at the best cost.
- Access solutions that give members new ways to lower their drug cost.
Direct-to-Employer Contracting
Many MedBen clients blend their RBP plan with direct-to-employer (DTE) contracts, which promote the use of quality care through local providers. In exchange for encouraging members to visit contracted facilities, providers bill the plan at mutually agreed-upon rates.
MedBen has been facilitating DTE contracting for over a decade with doctors and hospitals across the Midwest, and we continue to gain access to more exclusive DTE contracting. This strategy ensures that when members utilize area providers, they receive the best pricing options available.