What is Reference Based Pricing?
Reference Based Pricing (RBP) is the amount of money your health plan has determined it will pay for specific medical services. A reference price is often used to ensure that payments to providers are reasonable.
Examples of Reference Prices Include:
- Free Market Price, such as KPPFree™, online retailer, or another market price option.
- Healthcare Bluebook Fair price.
- A percentage above the amount paid to the provider by Medicare
Many benefit plans utilize RBP for out-of-network benefits, or as a replacement for a PPO network. If you have questions about your RBP benefits, please Contact Us.
How do you know if your plan is contracted with a network?
To determine whether your plan has contracted with a PPO network, review the Medical Plan section of your ID card, log in to our Secure Benefit Portal, or contact us.