HEALTH CARE PROGRAM DETAILS:


The American public has been pushed over the years to believe that they need full health insurance coverage that will cover almost anything, even a routine office visit. We look at this situation and ask why? This cost can be in excess of $700 per month, even for a healthy family. How many people really spend that kind of money on their health care? Very few. We don’t carry auto insurance that covers oil changes, tires, and new spark plugs. Why? Because it would be too expensive, and wouldn’t be worth it to us.

We challenge you to look at that situation and ask why, and what can you do about it? Think about this.. .the average healthy individual requires hospitalization only once every 20 years. But, they carry a high-cost insurance policy because they are afraid of that rare event. What if we told you that you can still prepare for that event, while saving money at the same time?  Rethink the way you look at health care costs, take advantage of the Renco Direct program, and you and your family may save thousands of dollars over the course of a few years.


Renco Direct offers its members access to savings on almost any kind of health care: hospitals, doctors, lab tests, dentists, vision care, prescription drugs, hearing aids, chiropractors and more!


A member enrolling in the program can also include the following dependents in the program at no extra charge:

  1. His or her spouse or significant other. (The significant other must be residing with the member.)
  2. Unmarried children and step-children under the age of 26 who are living with the member (or a former spouse) or are enrolled in school.
  3. Handicapped children who are over the age of 26 who qualify as IRS dependents of the member.
  4. Parents and grandparents who are residing with the member who are over the age of 60.
  5. Related children (nieces or nephews) who are IRS dependents of the member.
  6. Foster children of the member who also meet the criteria in point number two.


Medical providers are becoming increasingly unhappy with the managed care industry (particularly HMOs) because they are often not allowed to give their patients the care they believe is necessary and because they are forced to accept reduced rates (that are often below their costs) while often having to wait 30 to 90 days or more to get paid for their services.


Patients are becoming increasingly unhappy because they can no longer get the care that they and their doctor believe is necessary. With insurance companies making it more difficult to obtain adequate care, and refusing to pay many of the bills, many people are left out in the cold with nowhere to turn.


Renco Direct provides access to two of the largest Preferred Provider Organization (PPO) networks in the United States.  This is NOT an insurance program.  It is a simple way to obtain substantial savings on all of your health care needs through access to lower, pre-set PPO rates. Savings on doctors, hospitals and other services (lab tests, x-rays, etc.) are offered through PPOs. Our PPOs are two of the top in the United States. Some networks simply offer a straight discount off of a provider’s service. When you are dealing with a discount, there is often no way to tell if you are truly getting a savings.


For example, if you were buying an item, and the person you were buying it from did not have a “published’ rate, so you didn’t know what the regular price was, what’s to stop them from raising the price before applying your "discount"? Nothing. On the other hand, if there is a set fee schedule, that already has the "discounts” built in, with someone to monitor the process, you would know that you are getting the agreed-upon rate. That is the reason that most reputable medical PPO networks base most of their fees on fee schedules rather than using a discounted percent.


With a complex network of providers, there has to be a way to ensure standardization. This is done with the CPT4 code. CPT4 codes organize all of the services available for proper pricing and documentation. When a doctor files a claim, he or she must provide a CPT4 code for payment. For each procedure or test there is a specific CPT4 code. The price that is attached to that code is known as the PPO Allowable.


EXAMPLE:

A good example would be a Renco Direct member who went to see their doctor for the flu. Their visit was a standard office visit, and they are an established patient. When it came time to pay the bill, the receptionist billed a CPT4 code of 99212 which is the code to describe a standard office visit, for which they normally billed $50. The fee schedule rate for that particular procedure code in that particular city, however, was $33. Therefore the PPO Allowable was $33, and the Renco Direct member would only pay $33, which is a savings of $17 (34% off of $50)!


There are no claim forms or other paperwork to file.  Most providers will provide you with the PPO Network price immediately during your visit. There are NO LIMITATIONS on the use of the program, regardless of your health condition.  There are no annual or lifetime maximums.  You CANNOT be refused due to pre-existing conditions.


Simply stated, doctors and hospitals can pretty much charge whatever they want.  However, if they are part of a PPO network, then they are obligated to honor the agreed upon rates that are determined by the PPO network.  Renco provides you direct access to these lower PPO rates WITHOUT the expense of an insurance middleman.  You simply get direct access to lower rates. You save money.


Renco Direct is a program of choice, access, savings, and responsibility. The program provides choice of doctors and other medical providers without the red tape of having a third party looking over your shoulder to decide what services you can receive. It provides access to some of the best medical providers in the industry, at a savings generally ranging from 10% to 50% on doctors and 10% to 80% on hospitals. And, it requires the responsibility on the part of the member to pay the providers (at the reduced rate) at the time of service. We often refer to “self-managed care” when discussing the program because you are in charge of your health care.


Renco Direct was formed on the simple premise of allowing access to the same networks (and thus the same prices) that the insurance companies have been using for several years. Have you noticed that almost all health insurance policies require some type of network to be utilized these days? That is because the savings are significant, and the insurance companies don’t want to pay the asking price. Renco Direct opens the door to the same savings to anyone who can pay the bill on a timely basis. Renco Direct also strives to be the advocate for the patient—providing them with the information they need to make informed and responsible decisions about their health care.



What Makes Renco Direct Different:
While there are many differences, we want you to clearly understand the benefits that distinguish Renco Direct from our competitors.

We Explain Our Program:
Did you know every member in our physician and hospital program receives their member packet with a special message attached telling them to call us before they see a doctor or hospital? Why do we go to this additional trouble and expense? We want to welcome you, explain the program, and make sure that you know how to make an appointment and maximize your savings. Did you know that none of our competition does this? The competition seems to just leave it up to you to figure it all out.

We Re-Price Medical Bills:
Renco Direct has a toll-free automated re-pricing number that doctors can call and get instant pricing (the PPO allowable rate). The re-pricing center will also work closely with hospitals to get the best possible price on those bills as well.

We Have a Hospital Program:
Please understand that we DO NOT display hospitals on our online provider searches. This insures that members call customer service to set up hospital stays to insure that everything goes smoothly for members. We have the ability to arrange for you to stay at in-network and out-of-network hospitals, this is why it is important for members to call us to prearrange their hospital procedures. We instruct everyone to contact us before any scheduled hospitalization so we can actively be involved. We assist in locating the best hospital. We can explain the differences and even intercede with the hospital.

We have TWO Prescription Drug Programs:
On your health care website you will have access to two different prescription programs that work hand in hand with each other: Our free Rx card and the Renco Rx Aid $20 name brand program.

1. Free Rx Card:
You can get a completely free Rx card that will enable you to save from 10% to 85% on prescriptions at your local pharmacies. We also offer a best price mail order program that will save at least $5 on the best retail price quote on brand name and generics priced over $10 or 10% below AARP pricing with no postage or dispensing fees.

2. Renco Rx Aid:
The other part of our prescription offering is our Renco Rx Aid $20 name brand program. If you qualify, you will then be eligible to receive your prescriptions for just $20 per month, per prescription. Go to your health care website, click on the “expanded list” link or “enroll now” and take a look at the top 250 drugs that are on the program along with the income qualifications. See for yourself if you qualify to be on the program based on the income and other guidelines.  This may save you hundreds, or even thousands of dollars.

We Are Accessible:
Do you know where you can find our telephone number? It’s all over the place, on the ID card, in the packet, in our letters. In addition, it is toll-free too! How about our competition? Many of them never reveal their phone number at all! They hope that if you have a problem that you will call the network itself and maybe they can help you.

Call us. Guess what happens. We answer. We call it patient advocacy. We are here for you, because we want you to be here for us!

While the premise is simple, making it work properly is much more challenging. For example, doctors are generally in several different networks. Each network has their own fee schedules for each of the approximately 10,000 codes under which the providers can bill. It is understandable, then, that the typical doctor’s office wouldn’t know what to charge a patient who has access to the network, but is responsible for paying immediately.

First, someone who is knowledgeable about the program and managed care must be available to answer the providers’ questions, particularly when it is the first time they have encountered the program.

Second, the ability to quickly find out how much to charge a patient must be addressed. Renco Direct publishes a toll-free number on the ID card to assist the providers in these areas. Our knowledgeable customer service representatives can quickly and properly explain the program to the physician or his or her office staff to assure the acceptance and verify eligibility of the program. Also we provide the member a “Dear Provider” letter in their fulfillment kit that they can take with them to the doctor to explain how to process our card quickly without the need for the doctors office to make a phone call if they have basic questions. Members should be instructed to take that letter in with them the first time they visit their doctor. Renco Direct understands that our program must be transparent to both the consumer and the provider.

The Renco Direct program works well hand-in-hand with insurance. With our program you can use our PPO rates to help you pay down your deductible. For instance, with traditional insurance, if you have a $1000 deductible and you go to the emergency room and have a $1000 medical bill you would be $1,000 out of pocket but your deductible will have been met. Let’s say, for example, we get that $1000 medical bill reduced to $500, what happens is the traditional insurance company will see that you paid a $1,000 medical bill and your deductible is met even though you only paid $500 out of pocket!

If you have an 80-20 plan or a 70-30 plan we can work well there too. By having our program we can also take that 20 or 30% that you are responsible for reduce that amount too. Let’s take a $10,000 medical bill. If your deductible is met and you have an 80-20 plan you will be responsible for $2,000 out of pocket. Add our program and we can reduce that $2,000 to for example $1,000 or even less. Pretty cool huh?

So, if you have the Renco Direct program with a high deductible, you simply use the program until you meet the deductible, and you’ll always get the best price immediately.


As a customer, all you want to know is that when you go to the doctor that you receive the service you require, and that you receive the savings you deserve. All the doctor wants to know is that when he or she provides you a service that they will be paid the contracted rates. Renco Direct ensures that this is the case by taking a hands on approach with all of our member’s medical encounters. We explain it, administer it, and service it. This approach is crucial for long-term stability and growth.


 

Questions?

Contact us:


310-619-3055