Exec payment arrangement

<p>Hi Guys,</p> <p>Hope all is well.</p> <p>I need some help with the Executive Plan and Oncology Treatment.</p> <p>The Oncology Benefit is structured to pay up to 100% of the DH Rate.</p> <p>However if the doctor is on Classic Direct Payment arrangement on an Executive Plan it states that provider will be covered up to 300% of the Discovery Health Rate IN and OUT of hospital.</p> <p>The issue is that Oncology only pays up to 100% and doctor is not allowed to balance bill on an Executive plan but on the Classic Comp plan the doctor is however allowed to balance bill.</p> <p>Provider and member is worse of if the member is on an Exec Plan – Which member pays more for L</p> <p> </p>