What is Fair Health?

March 29th, 2018 Expert Medical Biller

MBA has contracted with FAIR Health to assist in determining UCR for our Medical Expense Evaluations and Code & Cost Evaluations. Fair Health is a non-profit organization that collects charge data from private insurers and health plan administrators from across the country. They implement various statistical methodologies to compile the data and determine values at varying percentages, based on geographical location.

The central mission of FAIR Health is to promote transparency in the field of healthcare costs. The organization was established in 2009 as the result of a settlement of an investigation by NY State into the use of Ingenix’s database of reimbursement fees for out of network health services. The Ingenix database was often seen as biased given the fact that it was a subsidiary of United Healthcare, at the time the second largest insurer in the nation. Therefore it was found that Ingenix may have had incentive in setting rates low so insurance companies could underpay medical providers for out-of-network services.

More information regarding FAIR Health, its methodologies, data collection, validation and security can be obtained at www.fairhealth.org.

Medical Billing Analysts (MBA) is a Nationwide Medical Billing Expert service with offices in NJ, NY, FL, TX, CT, GA, NV, and CA. To see how MBA can assist you in documenting the damages in your Personal Injury cases, consult www.medicalbillinganalysts.com or call 800-557-6141 for a proposal containing the experts’ professional qualifications, fee schedule, and sample Medical Expense Evaluation Report.