Getting Members to Stop Treating Plan Dollars Like Monopoly Money

By Allison Binning

Over tested and Overcharged

What if your employee got into a car accident on their way to work? They drive themselves to the emergency room–their pain is noticeable, but not bad enough for that ambulance bill–and sit in the waiting room. Their neck hurts when they turn to one side. They wait over an hour to see a doctor. Finally, when they get into an examination room, the doctor calls for a series of tests, and they sign a financial consent form to get a CT scan. They’re thankful that you don’t need an invasive test or procedure. The CT scan doesn’t show anything significant, so a nurse simply hands them a Tylenol before they sign their discharge papers. They go home, and two weeks later they get the bill.


As the plan sponsor, you are providing coverage and footing the massive bill associated with this episode. Despite the lack of treatment the employee received, their bill exceeds $4000, thanks largely to the $7000 scan “discounted” to the in-network charge of $2500.


And it isn’t until a few weeks later that they learn that the radiation dose of a CT scan is equivalent to more than 100 chest x-rays. Exposure to CT is estimated to cause over 2% of cancers diagnosed annually in America, and a lack of standardization in the practice results in a large variation in radiation dose. Since their immune system is already compromised by another chronic illness, they would have declined the CT scan had they known how much radiation was involved! And that Tylenol that the doctor gave them, which cost 100 for $7 at the store on their way home? It costs you and your employee $15 for a single pill. This is a massive bill for your employee, and it’s also a large bill for your company.


The lack of patient education in America isn’t just a health problem–it’s a financial problem. Al Lewis, CEO and Quizmeister-in-Chief of Quizzify, lists a few specific circumstances in which plan members may be overtreating and overpaying for healthcare services:

  • Americans get massive numbers of back scans, cortisone injections, and back surgeries. “Our healthcare trivia quizzes are set up to teach people that 80% of back pain will go away on its own, but 80% of people with back pain are convinced they are in the other 20%.” Waiting is the best solution most of the time.
  • Filling cavities doesn’t cost much, but people hate it, and it is by far the most common clinical procedure. Yet 75% of them don’t need to be filled anymore because they can be treated in 2 minutes by painting on a simple solution costing $35.
  • Most importantly, people are paying twice as much as they should be paying for ER services and emergency admissions.


What if You Had Quizzify2Go?

Quizzify2Go provides a 29-word financial consent form to replace the hospital’s, saving you money from unnecessary treatments or tests. “Using Quizzify’s Financial Consent instead of signing the hospital’s caps your fees at 200% of Medicare,” Al says. “And there’s not a thing the hospital can do about it. For non-elective care, federal law makes them treat you even if they don’t like the way you pay.”


Quizzify2Go works outside of emergency situations, too. It also provides employees with a better understanding of the treatments, tests, and medications that their doctors order. Their Doctor PrepKits provide a “virtual GPS for doctor visits from acne to zoster.” Imagine having a virtual assistant by your side during doctor visits, providing you with a wealth of information and questions to ask. It arms you with a list of insightful questions to ask your doctor, like the side effects of medications or any dietary restrictions or drug interactions you should be aware of.


Lauren Roberson, Head Nurse Advocate at Connect Healthcare Collaboration, says that Quizzify’s PrepKits provide her and her nurses with a tool of comfort and knowledge. “As we have often found in helping members with medical conditions, they find themselves scared, confused, and hopeless,” Lauren says. “Those feelings play a huge role in efficiency and preparedness for doctor’s visits related to their conditions.”


Recently, Lauren helped a plan member through their cancer diagnosis using Quizzify’s PrepKits. She said the member felt that “their head was in a fog” and didn’t even know where to start with their diagnosis. When Lauren provided the PrepKit, the plan members had time to prepare for their visit by reviewing the questions and information provided by Quizzify. Thanks to the PrepKit, the plan member could mentally prepare for the doctor’s appointment and feel more comfortable with their care plan. These PrepKits allow employees to be their own healthcare advocates, which improves outcomes while lowering overall healthcare costs.


Educating Your Workplace

During open enrollment, Quizzify provides customized benefits education quizzes. Other seasonal quizzes include January’s on Habits and Resolutions, and June’s Summer Hazards.


But brokers and employers can begin working with Quizzify almost immediately, at any time of year, with whatever curriculum suits their demographics. “Literally we could start tomorrow,” he says, “We’ve done all sorts of SSOs and other linkages and can get them running in no time.”


And the ROI is almost as fast. Employees begin taking the quizzes and using Quizzify2Go for common issues, like emergency room visits, cavity filling, or scans. “In a group of 1000, you have about 30 of those three things in total per month,” says Al. These common doctor and ER visits can create a mountain of unnecessary costs if your employees aren’t trained advocates for their healthcare.


“Is there any other line item where employees get an unlimited budget and no training in how to spend it?” Al asks brokers and employers. Patient education is the key to wiser healthcare decisions, leading to happier, healthier employees and substantial cost savings. “Wiser employees make healthier decisions,” Al says,” and healthier decisions save money.”


We are proud to feature Quizzify on The Granite List.

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