HEALTH CLAIMS MANAGEMENT

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



Health Claims Management is a new way for Benefit Advisors and employers to mange their health claims. We break down silos by creating a customized platform for each employer. Products can originate from the claims payor, Benefit Advisor, or HealthKeys, as our Communications Platform will seamlessly integrate all services. Data Analytics and Predictive Modeling is used to identify opportunities and most importantly measure results!

Administrative Services

Communications Platform

We create a customized "destination" for employees

  • All services in a single                 location
  • Coordinated Incentive                 Management
  • Secure targeted                           communication
  • Maximize the savings                 potential for each product

Data Analytics & Predictive Modeling

 Employer's claims data is used to measure all services

  • Specifically designed for             managing claim costs
  • Identify opportunities and         measure program efficacy
  • Employer's and Advisors           have access, creating a high       level of accountability

Integrated Member Advocacy

We help members use the health care system to minimize their out of pocket expenses

  • Care Management                        supports good decisions
  • Advocacy supports health          system understanding
  • Electronic and secure                  outreach increases                      engagement

Products

Claim Avoidance

Disease Management and Wellness are unified into a single product which forms the foundation.

  • No fuzzy ROI calculations           or self-reported data
  • Efficacy measured based           on improvements in:                   closing gaps in care,                     preventive measures, and         biometric screening results

Hard Dollar Savings

Reduce specific claims cost and employee out of pocket expenses. We measure results based on reduction in claims cost

  • Telehealth
  • Medical Transparency
  • Direct Contracting
  • Specialty Drug Tourism

Other Savings Options

We identify and make accesable,  little used claims savings services offered by claims payors and PBMs

  • DIabetic supply discounts
  • Manufacturers Assistance          Programs
  • Low cost pharmacy locator
  • Therapeutic optimization            programs