HealthComp open network, too good to be true?

[sad-caterpillar-4]

My coworker swears by HealthComp and says you can go anywhere in the country, no network limits. I'm used to the usual PPO runaround. Has anyone had billing issues or surprise charges with them?

 

[Hugo mum]

My coworker swears by HealthComp and says you can go anywhere in the country, no network limits. I'm used to the usual PPO runaround. Has anyone had billing issues or surprise charges with them?

well from the little I know, their customer service can be tough to reach, and issues with claim denials aren't uncommon, if you go with them still, make sure all providers are in network, keep good records, and be ready to push back if things go off

 

[sad-caterpillar-4]

Thanks for the list of potential issues to watch for. Your point about making sure providers are in network is the part that I find confusing. How can they market it as an open network if you still have to verify providers like a PPO?

 

[WM.Genee]

My coworker swears by HealthComp and says you can go anywhere in the country, no network limits. I'm used to the usual PPO runaround. Has anyone had billing issues or surprise charges with them?

Your coworker is right in that you can go to any provider you want, which is the "open network" part, but the key difference is what you'll pay.
HealthComp often uses a reference-based pricing model, which means they decide a fair price for a service.
If your provider charges more than that, you could be responsible for the difference, which is called a balance bill.
This is why it's not a PPO in the traditional sense because it's less about a provider being in-network and more about how the claim is paid.
You should always check the Explanation of Benefits carefully to make sure you won't get a surprise bill.
If you get a bill that's higher than what the EOB says you owe, you'll need to call HealthComp's customer service to get it sorted out.
It's a different way of doing things, so you have to be proactive about your billing.

 

[InsureMeNow]

Absolutely! It's super flexible, but that reference-based pricing can really sneak up on you. You've got to keep an eye on your EOBs, trust me it's important

 

[sad-caterpillar-4]

So even though I can technically go anywhere, the real issue is whether the provider accepts HealthComp's pricing without pushing the extra cost back on me. That's a big shift from what I'm used to with PPOs.

Have either of you had to deal with a balance bill personally? @WM.Genee @InsureMeNow

If so, how long did it take to get resolved once you contacted HealthComp? Trying to get a realistic sense of what kind of delay I'd be looking at if something goes sideways.