Flexible, customizable strategies for reducing the cost of healthcare for medical payors
±«ÏÊÄ¤ÊÓÆµ offers a range of data analytics-driven healthcare cost management services that can be combined to help your organization strike the right balance not only today, but also when priorities shift tomorrow. Our comprehensive, transparent, data-driven and defensible analytics-based services include: reference-based pricing, negotiated agreements and Value-Driven Health Plan services.
Data & Decision Science ±«ÏÊÄ¤ÊÓÆµ
±«ÏÊÄ¤ÊÓÆµ offers a variety of solutions that apply modern methods of data science to drive optimal benefit plan design, improve healthcare outcomes, and reduce the total cost of care. Our suite of services support virtually all types of payors including: employers, brokers and TPAs; medical, supplemental and stop-loss carriers; and benefit administrators and PEOs.
Beginning four decades ago as a New York hospital network, ±«ÏÊÄ¤ÊÓÆµâ€¯today has direct contracts with more than one million providers across the country through our PHCS and ±«ÏÊÄ¤ÊÓÆµ Networks. Our clients enjoy flexible network configurations that fitâ€¯theirâ€¯precise needs, depending on whether they seek a nationwide primary PPO, or a regional primary PPO with a complementary arrangement.
Payment and Revenue Integrity ±«ÏÊÄ¤ÊÓÆµ
±«ÏÊÄ¤ÊÓÆµ helps our clients to eliminate waste and abuse by preventing, correcting and recovering incorrect payments. We track healthcare claims through their entire lifecycle by identifying improper charges before and after payment. Our services are connected, making it possible for us to not only help recover inaccurate claim payments, but also to correct the root cause for the incorrect payment, thereby stopping the issue from occurring on future claims.