Health Claims Management

We manage medical and RX claim costs!

Health Claims Management is a comprehensive approach for self-funded employers to reduce their medical and RX claim costs. It includes our Cost Containment products and Health Risk Management service. Business as usual has not produced the claims savings results most employers are looking for, so let’s change the discussion! We create a transparent environment where employee engagement and health claims literacy form an integral part of our solutions. Employers can see our process and verify our results. Now we can offer employers and employees guaranteed savings, and an action plan to access those savings!

Yes, we impact claim costs!........How do we do it?

  •  We have assembled and coordinated a comprehensive menu of cost containment products designed to measurably reduce the cost of certain medical            and RX Claims.
  • Employee engagement in these Cost Containment products is an integral part of our process, which is supported in several ways:

           1)  Employees share in the savings, creating a win/win scenario

           2)  A Secure Communications Portal 

           3)  Transparency

           4)  Improved Health Claims Literacy

  • Our Health Risk Management program is powered by a data analytics tool, allowing us to identify and resolve specific health risks to avoid future claims
  • We make it easier for groups of 25-99 employees to consider self or level-funding. We use Verikai, a sophisticated data mining tool instead of medical               questionnaires to “qualify” employers
  • Savings are always measured and transparent for the employer and Benefit Advisor

  • All products and services are fully integrated with our TPA, PBM and Stop Loss carriers, for a seamless employer and employee experience.

We acknowledge and thank our partners for their support!