How we work with brokers
We’ve created a solution that takes the confusion out of benefits administration. Benefits are complicated but they don’t have to be.
How it all works together
Health plan administration
We’ve carefully curated a designed workflow and administration process to help members get the support and care they need through the following services and initiatives:
- Dedicated team
- Employer & member portals
- Adjudication
- Eligibility & auditing
- Wellness programs
- Reporting & analytics
- Stop-loss
- Billing services
- Regulatory assistance
- Subrogation
- Network access
- Customer service
- Personal assistant service
- Digital ID card
- Utilization review
- Case management
- Flexible benefits
Extensive network coverage
With access to a broad range of provider networks, you can customize your care options to align with your needs.
Top tier services with trusted partners
- Regional PPO networks
- Narrow networks/ACO’s
- Reference based pricing
Managing cost
Here’s how we help
Deep quality assurance
Our Quality Assurance (QA) program is the product of years of experience and innovation. Our QA practices are designed to drive claims accuracy and quickly detect fraud and abuse.
Integrated utilization management
Our Utilization Management team works closely with our Claims department to provide an unrivaled continuity of care. Services include utilization review, case management, wellness programs, and disease management.
Dedicated Stop-Loss team
Our Stop-Loss team uses proprietary software to identify claims that are eligible for reimbursement and monitor receivables from stop-loss carriers to groups. We also have in-house attorneys available to assist in appeals of denied reimbursement claims.
Multifaceted cost containment
Our Cost Containment team uses a number of practices to capture savings. Services include fee negotiation, subrogation, eligibility auditing, stop-loss reporting, and coordination of benefits.
Claims accuracy
We are leaders in the industry for claims accuracy and turnaround. Our nurses routinely review claims for medical necessity and our QA department audits high-cost claims to identify savings opportunities.
Transparent analytics & insights
Our solutions leverage the latest innovations to drive insights and produce real results. You’ll have access to our interactive HCNavigator report, benchmarking and predictive modeling tools, dashboards, and an extensive library of reports.
Plans & networks that work for you
Our plan-building experts work closely with you to ensure that your health plan works with your bottom line. And with access to a broad range of provider networks, you can customize your plan to align with your company’s needs.
Outcomes and results
Lowering costs for a healthier member population
Data driven analytics & insights
- Full transparency into your data
- Zero in on emerging trends and risks with our interactive tools
- Forecast outcomes and take action using predictive modeling
- Benchmarking tools that identify risk categories and areas for improvement
- An extensive library of standard and ad-hoc reports
Interested in HealthComp’s services?
Have a sales representative contact you.
