Claims
Adjudication
- Medical,
Dental, Short-Term Disability, Vision
- R
& C screening
- Code
Review
- Coordination
of benefits, including, subrogation, physician consultant review
- Quality
Assurance procedures, review and audits
- Fraud
control
- ERISA
claim review
- Eligibility
verification and maintenance
Health
Cost Management
- Utilization
Management and Case Management Services
- Regional
and National Network provider plans
Data
Analysis
- Monthly,
Quarterly and Renewal Analysis of Claims Experience
- Alternate
Benefit Plan Modeling
- Utilization
Management/Case Management Reports
- Monthly
Reinsurance Updates (aggregate and specific)
- Ad
Hoc Reporting as requested
Reinsurance
Services
- Securing
of stop-loss insurance bids and placement of coverage
- Tracking
and filing of stop-loss insurance claims
- An
extensive list of Reinsurance carriers
Administrative
Services
- Flexible
Benefits
- COBRA
- Enrollment
and Eligibility Maintenance
- Identification
and Prescription Card Management
- HIPAA
- New
York & Massachusetts Surcharge
Communications
- Custom
Enrollment Forms
- Flex
Plan Description and Enrollment Kits
- Employee
Booklets
- Posters,
Slides, Payroll Stuffers, Tent Card, etc.
Document
Preparation
- Plan
Document/Summary Plan Description
- Plan
Amendments
Accounting
- Preparation
of Monthly Statements of Deposits, Expenses, and Claims
- Preparation
and Distribution of 1099 forms
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