CUSTOM PROVIDER NETWORKS

All provider networks are not created equal and they do not

constantly improve upon their discounts. On average a tiered

network can save a plan 14% or more. We direct your members

to lower cost provider in order to save your member and plan money.


MEDICARE LIKE RATE & REFERENCE BASED PRICING

We provide Medicare Like Rates for Indian Tribal Entities and

other self-insured employers. Our proprietary software takes the

Medicare and Market pricing and develops appropriate rates for

your plans negotiating power.



BENEFIT PLAN CLAIM AUDITS

If your plan is self-insured, it’s critically important that every

healthcare dollar you spend is for legitimate expenses. The

department of justice has been tasked with bringing in over $17

billion dollars in fines this year. Part of what we do is to keep you

in compliance with all federal laws and regulations governing ERISA.

We audit 100% of your claims for payment accuracy according to your

plan document and stop loss contract.


LARGE CLAIM AUDITS & NEGOTIATION

The average hospital claim has increased 25% to 40%. High

dollar claims average between 50% to 80% of your plans overall

claims costs. Our unique skills, medical knowledge and proprietary

Auditing system.


SUMMARY PLAN DOCUMENT REVIEW AND RE-WRITE

The goal of the federal government is to enforce the Affordable

Care Act (ACA) and other federal regulations. They have started

regular audits of group health plans. These audits extend into

compliance of ERISA. We will review your existing SPD for

compliance or customize one for you.


PRODUCTS AND SERVICES

CUSTOM    HEALTHCARE   SOLUTIONS

Health West has been creating custom healthcare  solutions for employers and brokers since 2009. We created our first CUSTOM provider network in Yuma, Arizona for a self-funded school district. We realized that there are many solutions that lower healthcare costs and provide quality that were not being implemented throughout the healthcare industry. Our goal is to think outside of the healthcare box and provide innovative, tested solutions that make sense and actually save our clients time and money. 


Our independence allows us to prioritize and select solutions that are in the best interest of the employer and the member. Then provide the knowledge and power to make and implement changes to save money.

With over 50 years of combined experience in the healthcare arena and over 30 years of experience in healthcare insurance, we specialize in self-funding, consulting, claims administration and data analysis for employer sponsored health plans. We have been able to negotiate multi million dollar contracts with hospitals, physicians and other ancillary providers.

CUSTOM  HEALTHCARE SOLUTIONS