We understand that the expectation of brokers, consultants, third party administrators and the underlying employer is to partner with a stop loss provider that flawlessly executes the reimbursement process.
With this knowledge in mind, employing experienced, professional and friendly staff is at the center of our claims administration approach. The team opens the doors to facilitate communication between medical management providers, claims payors and other interested parties. The result is a collaborative environment and exchange of information that addresses shared goals.
• Efficient workflows for paying claims accurately and effectively
• Seamless interaction with frontline administrators
• Each policyholder provided direct access to their assigned claims analyst and claims supervisor
• Claims authority to adjudicate and pay specific claims promptly. Complete claims submissions are routinely reimbursed in less than ten working days
• Comprehensive claims kits are provided to assist Third Party Administrators with streamlined claims processes
• Electronic funds transfer for claim reimbursements
• Access to leading-edge cost containment programs including transplant networks, specialty pharmacy, re-pricing services, case management, dialysis networks and many more
• Assistance with negotiating complex and high dollar claims