Frequently Asked Questions

What is On-Demand Health Insurance?

On-Demand Health Insurance protects consumers for the majority of health care services through premium-reduced Core Coverage, and gives them the flexibility to purchase Add-In coverage, at any time, for select services tied to the most varied treatment and cost options. Add-In options are available at the service, provider and location level, and they serve as personalized supplements to the consumer’s Core Coverage.

Bind’s On-Demand Health Insurance is also a more transparent insurance experience. When consumers access care, their total costs are made clear through a straightforward copayment structure instead of confusing coinsurance and deductible limits. And they manage their complete health insurance experience, including Add-In purchases, easily and directly through their Bind app via a desk, lap or mobile device.

What is the process for purchasing a coverage Add-In? Is this in real time?

Consumers manage their coverage, compare costs, and purchase Add-In Coverage directly through the Bind app. They can review provider and cost options, and even review alternate treatment options within the app. Free expert second opinion and virtual care services are also provided.

Add-In Coverage purchases are in real-time – their Core Coverage is immediately supplemented when Add-Ins are purchased, but billing does not begin until the service trigger event (i.e., surgery date, procedure initiation, etc.)

The majority of health care services, including urgent and emergent care, are fully covered by the consumer’s Core Coverage. Add-In Coverage options are restricted to planned services where the range of possible modalities and treatment settings vary.

With Bind, what opportunities exist for providers?

Providers define and price their services in order to make them available to all of the employers and related employees that use Bind to administer their health care benefits. Unlike a traditional benefit, the Bind benefit allows people to purchase additional coverage at the moment in time they are facing a health issue. Bind allows members to see all of their available options and associated prices, giving you as a provider the chance to compete and win at the time of consumer need. Bind will collect and share rich data on these decisions with you, so that you can further refine your service offerings to achieve organizational objectives.

At the outset, you also have the opportunity to help Bind and its employer customers determine which of your services are good candidates for Add-Ins. Bind’s critical distinction between the Core and Add-In Coverages is not one of medical necessity, but is instead characterized by time and choice. Add-Ins are offered in situations where a member has time to plan for the care they need and one of the following two criteria applies:

  1. Treatment options exist with similar clinical outcomes

or

  1. The cost of these treatments and services varies widely by provider and/or setting

Is Bind looking to negotiate allowed amounts for services?

No. At Bind, we view ourselves as the conduit for connecting the services providers offer to the employers and consumers looking to purchase them. We will ask for you to provide us the amount a provider is willing to accept for a service, and then translate that amount into the consumer’s cost, which is a combination of premium payments and copays. We are interested in creating a collaborative relationship where the employer, provider and consumer mutually benefit. 

How will providers be reimbursed for Add-In services?

Fee-for-service reimbursement will initially serve as the payment methodology, but over time it is likely that the employers Bind serves will desire a shift to bundled payment methodologies.

Which providers are included in the network for Core Coverage, and how will they be reimbursed?

Bind will leverage PreferredOne networks for its Core Coverage network. For services under Core Coverage, providers will be reimbursed the same way that they are today.

How will members know how much their care will cost?

Bind has set copays for all care covered within the Bind plan. Members receive coverage immediately without a deductible or coinsurance. Members access pricing for all services easily through the Search for Coverage + Providers tool within the Bind portal or via the Bind app. This approach allows Bind to provide you a definitive amount due from your Bind customers prior to delivery of the service, enhancing your collection efforts.

How can a provider participate in the Bind network?

Bind is focused on developing direct contracts with providers for the services associated with coverage Add-Ins. Our intent is to allow providers the opportunity to more directly showcase and differentiate themselves around the Add-In services they offer to employers and their employees. We welcome the opportunity to discuss this more with you.

Can I participate in Bind’s provider workgroups?

Bind is interested in making things simpler for not only our members, but our provider partners, as well. We are in the process of developing two workgroups that will allow provider organizations to help us improve the way we interact with them. The first is a clinical workgroup where physicians can lend their clinical expertise to the design of our Add-In Coverages. The other is an operations workgroup where we are interested in working with administrators in simplifying and streamlining processes to make working with our benefit as seamless as possible

Can I participate as an employer?

Yes, we are looking to work with innovative employers that are looking to push beyond the status quo. We believe that our benefit design, in combination with the advances we are making in data science, will be beneficial for self-insured employers of any size. Therefore, we will work with any self-insured employer, as well as any fully insured groups looking to make the transition to self-insured status, that are looking to reduce their health care costs and improve the experience for their employees. To find out more about how our benefit can work for your organization, our contact information is at the bottom of the page.

How can I get employers in my market to participate?

Bind is interested in working with you to highlight our benefit to self-insured employers in your market. We believe that creating a collection of purchasers for your differentiated products is the best way to reward the innovation and value you create. If there are specific employers that you would like to speak to jointly with Bind, we would love to work with you in setting up time with those employers. In these meetings, we would envision Bind presenting our new benefit concept and you presenting the care solutions you could offer through this benefit

How can a provider participate in the Bind network?

For more information regarding participation as a network provider, employer or workgroup member, please contact Shawn or Matt:

Customer Service
888.720.7614