Personalized healthcare solutions for employers

Member benefits include:

• Local access to dedicated member services and utilization management support experts
• A local call center, including live chat and a 24/7 nurse line
• Self-management support for high-risk members to maintain their quality of life
• Relationship-centered approach: communication and integration across the member’s journey

• Constant investment in IT systems infrastructure to ensure accurate and timely processing, performance and protection
• Dedicated resources and technology to detect and prevent fraud, waste and abuse (FWA)
• Aggressive cost savings through subrogation, coordination of benefits and recovery services
• Creation and distribution of Explanation of Benefits (EOBs) to members and Explanation of Payments (EOPs) to providers
• Claims run-out estimation and payment

• Dedicated account executive and support team
• Single point of contact for client needs, including day-to-day operations, data analytics, project development and problem-solving
• Benefit design expertise that is data-driven and consultative with benefit plan modeling to bend your cost curve
• Secure 24/7 access to Planwatch, a web-based claims analytics and cost-of-use reporting tool