CONTACT US:
Phone - (888) 316-1933
Fax - (888) 316-8572
Custom Solutions
Our goal is to think outside the box and provide innovated
solutions that make a difference and save time and money.
We realized that there are many solutions that lower healthcare costs and provide quality that were not being implemented throughout the healthcare industry. 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.
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.
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 $17billion 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 paymentaccuracy 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.