EPISODE · May 19, 2026 · 39 MIN
Six Degrees Health - Risky Benefits S6E2
from Risky Benefits · host David Holloway-Boyd
Employers are fighting rising healthcare costs, and this week’s guest breaks down three powerful tools that actually move the needle. We sit down with Heath Potter, Chief Growth Officer at Six Degrees Health, to unpack reference‑based pricing, payment integrity, and member advocacy in plain, practical language.Heath shares how RBP replaces inflated PPO discounts with fair benchmarks—often around 140% of Medicare—helping plans cut medical spend by 25–40%. He also digs into the 18% claim error rate hiding in the system and why pre‑payment review on large claims is essential.You’ll hear how self‑funded employers can structure their plans with TPAs and stop‑loss, how provider education and single case agreements smooth the process, and how balance bills are typically resolved through negotiation rather than escalation. Plus, why facility claims are where the biggest savings live.A clear, actionable conversation for anyone looking to take control of healthcare spend.To listen in and subscribe to more episodes, visit our website: fbmc.com/podcast.
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Employers are fighting rising healthcare costs, and this week’s guest breaks down three powerful tools that actually move the needle. We sit down with Heath Potter, Chief Growth Officer at Six Degrees Health, to unpack reference‑based pricing, payment integrity, and member advocacy in plain, practical language. Heath shares how RBP replaces inflated PPO discounts with fair benchmarks—often around 140% of Medicare—helping plans cut medical spend by 25–40%. He also digs into the 18% claim error...
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Six Degrees Health - Risky Benefits S6E2
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