HEALTH CLAIMS MANAGEMENT

Hours of Operation: Mon - Fri 8:00am - 8:00pm





Let's Change the Discussion!

Our goal is simple and rational; reduce employer claims cost and employee out of pocket expenses. The tactics we use include a combination of claim avoidance and hard dollar savings solutions. Poor employee engagement, sketchy results, and a reliance on wellness as the only solution, has created employer doubt and apathy. Let’s acknowledge the challenges and develop a plan to fix the problem!


Improve employee engagement

Our Creative communications portal is designed for employee interaction and education creating higher engagement:

  • Transparent communication strategy
  • Improve health claims literacy
  • Integrated incentives
  • Targeted and secure communication

Pass the CFO eye test

We only use claims data to measure and verify results through our data analytics tool. No fuzzy ROI calculations or self-reported data is required

  • Claim avoidance products are measured through closing gaps in care and improvements in preventative protocols and biometric                   screening results.
  • Hard Dollar savings products are measured based on the "before and after" claims cost.


Control the process

Many of the claim saving tactics available to employers (Disease Management, Telehealth, and Medical Transparency) are controlled by  claim payors and have performed poorly. Without a business rationale to drive down a self-funded employers’ claims costs, and little accountability to perform, it is doubtful that investments will be made to improve the situation. Contractual obligations and competing business interests prevent innovation in other areas such as Direct Contracting and International Specialty Pharmacy. We think a change in the status quo is required to achieve the desired results. A single platform housing all products, controlled by the employer and Benefit Advisor is the most rational way to create a winning environment.  



Break down silos

Any product that impacts claims cost or reduces employee out of pocket expense can be profiled in our Service Platform. We educate employees and provide easy access for them to each product. Merging claim avoidance and hard dollar savings products into one platform creates administrative and communication efficiencies that can not be matched by the current siloed approach.