SELF-FUNDING vs. FULLY INSURING

Self-funding is a leading option for companies that are struggling with the rising cost of healthcare.  Independent studies have shown that Self-funding can cost as much as 40% less than comparable coverage with an insurance company.

HOSPITAL DIRECT CONTRACTS

 Direct Contracting allows employers and hospitals to develop innovative partnerships that allow self-funded plans to operate more efficiently outside of fully insured and PPO network narrow rules. 


INTENSIVE CLAIMS MANAGEMENT

Cost savings is so much more than just processing, auditing and paying claims.  Intensive claims management and oversight begins before the claim is incurred and cans save as much as 15% on claims costs.


CUSTOM PROVIDER NETWORKS

Independent studies show that a custom, high performance network can save as much as 10-15% on claims cost.  Custom provider networks allow your members access to a wide range of providers by steer them to the best prices.


REFERENCE BASED PRICING

Employers are looking for innovative ways such as, reference-based pricing, to reduce health benefit plan expenses.

It is a  payment methodology whereby providers are paid for covered treatments  and services using a “reasonable fee” based on a reference point.

CLAIM NEGOTIATIONS

Hospital costs are sky rocketing and health plans can save an additional 20-40% by negotiating high cost hospital claims.  Claims Negotiation allows employers to take advantage of Reference Based Pricing with no out of pocket billing to the member.