HEALTH CLAIMS MANAGEMENT

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



Forms and Brochures

HealthKeys Marketing Brochure

Health Claims Management is a new way for self-funded employers to manage their claims cost. Fuzzy ROI calculations, the reliance on self-reported data, and a siloed approach to offering products, has created ineffective programs that have not produced the claim savings employers expect. It's time to change the discussion with employers and Benefit Advisors! Click here to download our brochure.

Communications Portal

Employees have access 24/7 to this mobile enabled platform. A tile is built for each product, service, or general information that an employer chooses. It may include videos, hyperlinks, and documents. Incentives are communicated and tracked for employees. Our unique transparent approach can be customized to fit any employee population. Click here to view The Platform.

Data Analytics/Predictive Modeling

Member level detail is one of the defining features of this service. Fully integrated with our products, this tool is designed specifically to support Health Claims Management. Tracking gaps in care and preventative services, we eliminate the need for self-reported data. Employers and Benefit Advisors have access to the appropriate level of data, and can easily follow out progress and collaborate on solutions. Click here to download a brochure.

Claim Avoidance (Disease Management and Wellness)

HealthKeys' proprietary Claim Avoidance program forms the foundation of our Health Claims Management Program. Our Care Managers securely reach out to those with chronic conditions to provide them with a Health Care Impact Profile (including their notes) which summarizes their gaps in cares and compliance with preventative protocols. Subsequent telephonic support and integration with incentive programs, is designed to improve compliance with these metrics which are easily measured through our data analytics tool. 

Direct Contracting-Surgical Centers

Freestanding out-patient surgical centers are contracted to provide services on a bundled basis. Employee out of pocket expenses are waived if this benefit is used. One step closer to true medical transparency, pricing is shared with employees and the employer and is compared to the same service offered through the claims payor. Savings  can range for 20-60%! Click here for a product flyer.

Specialty Drug Management

Specialty drug pricing is having a huge impact on an employer's pharmacy claim cost and employee out of pocket expense. Our partner has organized a special arrangement with a medical facility in The Cayman Islands to provide the same drugs from the same manufacturer at discounts that can range from 30%-70%. The patient's physician approves the arrangement and all travel expenses are included. Click here for a product flyer. 

Feasibility Study

HealthKeys provides a unique Feasibility Study which allows employers and Benefit Advisors to view the savings potential for any claim avoidance or hard dollar savings product we offer. This intuitive service is perfect for employers interested in looking “behind the curtains” to see the how and why their utilization patterns impact the financial viability of each product. Contact us for a personal discussion about how you and your client can benefit from The HealthKeys Feasibilty Study!