Redirect Health Broker FAQs

Redirect Health is a versatile platform that creates and manages healthcare solutions and products that meaningfully improve access and affordability for businesses and employees. Holding our mission at the forefront, Redirect Health provides personalized 24/7 access and financial consistency to members across the United States. We offer unparalleled nationwide 

Yes! Plans with 5-19 eligible employees satisfy penalty A (MEC). Plans with 20+ eligible  employees satisfy penalty A (MEC) and B (MVP). 

There is no medical underwriting with Redirect Health for groups or individuals.  So, it’s easy to get signed up and enrolled quickly and seamlessly. Some pre-existing exclusions may apply for individuals and groups under 20 employees. 

As a contracted broker, you will receive your own online store with a personalized enrollment link for your clients to learn more and submit their applications. We use the Employee Navigator BenAdmin system to enroll employees, where you can use your own login or ours. After enrollment, employee and dependent adds or drops are managed in Employee Navigator. 

We offer a flat rate commission of 6% to brokers. With low premiums and sustainable yearover- year rates of less than 5% increases, our plans see higher participation compared to other plans. This enables you to earn a higher commission while expanding your book of business and effectively meeting the needs of your clients. 

We understand that relationships with doctors are important, so we want to keep those relationships intact. Before a member calls their doctor, have them contact Redirect Health first by using the Redirect Health Member App, and we will schedule their appointment and ensure they are receiving fair pricing for the care they require. If their provider is not part of the PHCS network, we will work directly with them to establish a direct contract. The doctor's office wants to know how they will get paid, and our conversation with them is designed to give the office confidence in the payment process. 
 

 For non-formulary medications, members should not pay more than the Redirect Health discounted cost when they use the Redirect Health Member App.

Copay costs can vary based on the pharmacy, prescription quantity, and dosages, so we strive to find members the lowest prices! Make sure members always show their Member ID card in their Redirect Health Member App so the pharmacy has the most up-to-date information in their system.

Claims are requests for payments sent by providers to different entities such as clearing houses, payors, and TPAs. Claims from providers are handled by Redirect Health the same as they would be on any plan.

When a member uses the Redirect Health Member App to schedule, the necessary information is sent to their provider so they can get paid. With our patent-pending QuickPay system, providers are paid quickly - usually within 7 days and rarely more than 30 days. We even collaborate with providers to offer prepayment options if they can accommodate it.

Similar to a “claim,” a "bill" is a request for payment from a provider that is typically sent to the patient instead of the payor. At Redirect Health, we work directly with providers, so in more than 90% of cases, providers correctly send the claim to us for processing. However, there are instances where a provider's internal billing system may send a bill directly to the member, either instead of or before sending the claim to Redirect Health. This often happens when a
member sees their doctor without using the Redirect Health Member App.

It’s normal for a provider's bill to be sent incorrectly to a member and can happen regularly. In many cases, the bill may only be for the member's out-of-pocket responsibility, and it could be correct. However, there are situations when Redirect Health has not yet received the claim from the provider.