Noting that as much as $3.2 trillion a year in medical care is “secretly priced,” an entrepreneurial physician named Bill Hennessey is on a mission to unmask those costs for self-insured employers with the help of brokers and advisers. The secret weapon: an ability to identify by ZIP code known charges and claim allowables before services are actually rendered. The proprietary platform, Pratter, instantly identifies, itemizes and targets a host of outpatient procedures, seeks to break the confounding cycle of contractual arrangements with TPAs or insurance carriers that prevent employers from auditing their own claims.
One adviser working with Pratter is Steve Dalaba, co-founder and managing partner of WBS Benefit Advisors. He was surprised by the eye-popping variation of a simple lipid panel test in Pittsburgh, which a live demo of Hennessey’s transparent pricing tool pegged at anywhere from $25 to $1,900. “We fully believe that knowledge is power,” he says, noting how more careful shopping by employees will save their employer money as well.
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