Let’s Change the Discussion!

Our Health Claims Management Platform offers the c-suite a powerful strategic tool that will help manage their self-funded health and Rx claim costs. Employers can now “push the levers’ on any cost containment product, health risk management program, and unified incentive model, that align with their financial, operational, and employee‑experience objectives.

Our Health Claims Management program was designed to answer every self-funded employer’s primary question “how can I pay less for my health insurance”? The simple answer is: “pay less for your claims”! There are only two ways to impact claim costs, and we address both:

• Pay less for them (Cost Containment)
• Avoid them (Health Risk Management)

Measuring Results….Transparency Rules!

In most cases Cost Containment and/or Health Risk Management programs have not met expectations of MEASURABLY impacting claim costs. We have solved this challenge by taking advantage of the advancement in data analytics and transparency:

• We conduct a Feasibility Study using the employer’s claims data to show exactly where the savings will come from
• Verifiable savings average $125,000/100 employees
• All point solutions that we work with must answer two basic questions:

            o   How do you impact claims costs?

            o   How do you measure results?

• Engagement (the primary reason for poor performance) is improved through our Engagement/Communications Platform

Shared Savings

Managing costs does not have to mean shifting costs to employees. Using our Health Claims Management concept, we share savings with employees. We nudge employees to consider a low-cost high quality alternative provider, and if they accept, we waive co-pays, waive out -of-pocket expenses, or provide them with a percentage of savings, creating a win/win scenario.