Our commercials · OON / OOF · Spot J
Who pays when a doctor is out of network at the ER?
The real answer
An award in the federal dispute process is paid by the plan, not the patient: the patient’s share is figured on the recognized amount — under the federal rule the QPA, what the plan calls its median in-network rate for the service — and counts toward the in-network deductible and out-of-pocket maximum. For one kind of doctor in one state, the plastic surgeon in New Jersey, Provern measured the awards to the top organizations at 1.3 to 1.4 times what those doctors are paid in network elsewhere.
What is federal IDR? — answered from the law, on provern.org
One of the ads our agency made that we did not approve.
Advertised by a Third Party Advertiser. We are not affiliated. They advertise our prices. We contract the prices. The third party advertises and connects with you. We are not related.
The words on screen
- The ads our agency made that we did not approve. — Standard Healthcare
- ALWAYS CHEAPER / FOR THE PATIENT, / BY LAW.*
- UNLOCK YOUR FULL NETWORK!
- OON.
- In Network Doctors Near You: 100In Network Price Near You: $99,999Out Network Doctors Near You: 99,999Out Network Price Near You: $100The network, flipped. They only own the network. They don’t own the doctors, or you, or your choice.
- ooh, aah, OON!
- BUT WAIT. THERE’S MORE.
- AT ABOUT THE PRICE THOSE DOCTORS ALREADY TAKE IN NETWORK.*
- Provern’s measurement on one kind of doctor in one state: the awards sat at 1.3 to 1.4 times what those doctors are paid in network elsewhere. Your doctor may vary.
- ACCESS TO MORE CARE, / AT THE SAME PRICE! TODAY!*
The spot, :30
- Healthcare
- Unlock your full network! Every doctor in the country, yours — out of network! You already pay the in-network price, and out of network the award lands at about the price those doctors already take in network. Your patients save. You pay what you pay.
- The patient
- OON.
- The public
- ooh, aah, OON!
- The card
- OOF.
- Healthcare
- But wait. There’s more. It was in the plan the whole time. We called it a loophole.
- Announcer
- They only own the network. They don’t own the doctors, or you, or your choice. They own the idea that you have to play by the house.
- Cut to
- A stock photo, confusion. The card: ooh, OON! Go to provern. provern.org
The fine print, in full
Standard Healthcare is a parody. No real company is depicted. An out-of-network award under the federal dispute process is the plan's to pay, never the patient's: the patient's share is figured on the recognized amount and counts toward the in-network deductible and out-of-pocket maximum (45 CFR 149.110, 149.510). Provern's measurement on one kind of doctor in one state, the plastic surgeon in New Jersey: the awards to the top organizations sat at 1.3 to 1.4 times what those doctors are paid in network elsewhere, and 78% of the gap between the awards and the QPAs fell on self-insured employer plans. The protection covers an emergency at any ER and an out-of-network clinician at an in-network hospital or surgery center (45 CFR 149.110, 149.410). It does not cover a planned visit to an out-of-network facility: there the office's in-network discount is real, and the network tables say so. Advertised by a Third Party Advertiser. We are not affiliated. They advertise our prices. We contract the prices. The third party advertises and connects with you. We are not related.
CALL NOW!* *Your patient’s share is never more than their in-network share, by law — figured on the recognized amount, and the award is the plan’s.
How every spot ends
- The transition
Photo: Ernie Branson for the National Cancer Institute, public domain, via Wikimedia Commons · credits - The relief ooh, OON!
- The closer Go to provern
