How we work with brokers

business women working together

We’ve created a solution that takes the confusion out of benefits administration. Benefits are complicated but they don’t have to be.

business women working together

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.

Group 460

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 program is the product of years of experience and nnovation. Our QA practices are designed to drive claims accuracy and quickly etect 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 & 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
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Chad Harris

Chief Executive Officer

 

Chad Harris serves as the CEO of HealthComp and is a values-driven healthcare leader with over twenty years of experience running business process and information technology businesses as a senior executive. Chad has a reputation for creating and controlling rapid growth by focusing on the intersection of customers, market dynamics, and the new digital world.

 

Chad has held many senior executive positions and led global teams of more than 10,000 people across dozens of counties. Chad has grown both large and small businesses, from those with less than $100M of revenue to those producing multiple billions of revenue, focusing on delivery, customer satisfaction, and innovation to create market leadership.

 

Chad's philosophy is to inspire change by doing what comes naturally, putting the needs of others before his own, working incredibly hard, and focusing on "how" to accomplish things, never "if they can be accomplished."

Thomas Martel

Chief Growth Officer

 

Tom serves as the Chief Growth Officer at HealthComp. In this role, Tom focuses on strategic initiatives aimed at accelerating HealthComp’s growth nationwide. His passion lies in assessing market and enterprise structures and creating efficiencies that enable teams to deliver best-in-class performance.

 

Previously, Tom led Cigna’s largest employer segment, largest region which was comprised of several health plans including the two largest health plans. He worked closely with Market Presidents and their leadership teams to develop and execute local market strategy and deliver growth for the enterprise. Tom earned his degree from Saint Anselm College and holds certifications from The Wharton School and the Darden School of Business at the University of Virginia. In his spare time, he enjoys sailing and holds a Master Captain’s license with the U.S. Coast Guard. He is also active in community outreach programs including local food bank and shelter services.

Sanoj Balakrishnan

Chief Technology Officer

 

Sanoj Balakrishnan serves as the Chief Technology Officer at HealthComp. In this role, he oversees the company’s overall technology strategy and architecture, building secure and highly scalable distributed systems.

 

Most recently, Sanoj served as Head of Healthcare Digital Business and Technology at Cognizant, working with payers and providers in developing solutions that reduced healthcare costs and provided a best-in-class experience for members. Earlier in his career, he worked at technology organizations in a variety of software engineering and architecture roles. Sanoj earned his B.S. from University of Mumbai and Computer Systems Management from National Institute of Information Technology.

Justin Tran

Executive Vice President, Product

 

Justin serves as the Executive Vice President of Product at HealthComp. He has 8 years of experience in developing and delivering solutions that reduce health care costs, improve quality, and provide a best-in-class experience for members. Most recently, Justin was an Associate Partner and business unit leader at McKinsey & Company where he helped large carriers and healthcare technology companies build new clinical services and solutions for fraud, waste, and abuse. Justin earned his B.S. in Accounting and Data Informatics from Indiana University, Bloomington.

Tucker Stein

Chief Financial Officer

 

Tucker serves as the Chief Financial Officer of HealthComp. Tucker previously worked for The Boeing Company in a number of finance and strategy roles, most recently as a finance lead for the Transactions and New Business Development group. In this role Tucker led investments and strategic partnerships for Boeing’s Space and Communications portfolio. Tucker earned his MBA at Stanford’s Graduate School of Business and his Bachelors of Science at the University of Redlands.

Tom Georgouses

General Counsel

 

Tom is involved in multiple areas of HealthComp including Operations, Compliance and Legal Affairs. Tom was admitted to the California Bar in 1990 and started his legal career with Stammer, McKnight, Barnum and Bailey, LLP. When he left the firm to join HealthComp in 2014, he was the Managing Partner (he had represented HealthComp since 2003). In private practice Tom’s areas of focus included healthcare and transactional work. Tom holds a Bachelor of Science Degree in Business Administration-Finance from California State University Fresno and received his Juris Doctorate from San Joaquin College of Law.

Rishab Bansal

Chief Transformation & Operations Officer

 

Rishab serves as the Chief Transformation & Operating Officer at HealthComp. Rishab focuses on transforming and modernizing HealthComp’s operations to provide delightful and distinctive experiences to its members, providers, and clients. His agenda includes integrating all entities towards a One HealthComp vision, driving profitable growth, and delivering value and business outcomes.

 

In his former work over the last 2 decades, he has helped clients across industries to transform themselves by bringing industry-leading practices and digital and data-led disruption. As the trusted advisor to the C-suite, Rishab helped his clients leapfrog on their transformation journey to accelerate business outcomes and helped them unlock new opportunities to drive profitable growth, profitability, and enhanced experience for their employees and clients.

EDI Information

If you are a healthcare provider and have the capability to submit healthcare claims electronically and use one of the clearinghouses listed below, please use the associated payor ID to submit claims destined for HealthComp.

Clearinghouse Medical Payor ID Dental Payor ID
Availity 85729
Capario HCOMP
CareVu 85729
Dental XChange DX029
Emdeon/WebMD 85729 85729
Claimant.com 85729
I-Plexus Solutions 85729
McKesson (RelayHealth) 85729
CPID:
HCFA - 3206
UB - 2934
NDC 85729
Office Ally 85729
OptumInsight (Formerly Ingenix) 85729
Tesia 85729

We strongly advise that you confirm our payor ID with your clearinghouse before you submit claims electronically to us.
For questions regarding our EDI capabilities, please contact our EDI Coordinator



Elaine Davis

Chief Human Resources Officer

 

Elaine Davis serves as CHRO for HealthComp. Elaine previously served as CHRO for Continuum Global Solutions and has served in executive leadership positions for Xerox and GlaxoSmithKline. Elaine holds Bachelor’s and Master’s degrees from the University of California at Berkeley.