“Many benefit plans are bound by contracts they either don’t understand or have never seen” – Adam V. Russo
Advanced Medical Strategies Partners with The Phia Group on Innovative NetworkDx
MyHealthGuide Source: Advanced Medical Strategies, 4/18/2014, www.mdstrat.com and www.phiagroup.com
Lynnfield MA — Two powerhouse healthcare cost containment firms, The Phia Group, LLC, and Advanced Medical Strategies, have combined to create NetworkDx, a new, patent pending software as a service (SAAS) subscription-based offering that provides healthcare payors comprehensive analysis of the provisions in PPO contracts.
One of the most frequent struggles that any healthcare payor faces is PPO contract analysis. The larger the network, the more labor intensive the contract review process. With the Affordable Care Act substantially increasing the number of businesses that self-insure, more companies will be directly providing for their employees’ healthcare, thus increasing an already ubiquitous need for cost assessment. Knowing what the contract specifies for coverage is imperative.
Before NetworkDx, contract and network analysis was performed individually, with some analyses taking as long as six months. NetworkDx drastically reduces this time, making accurate analyses quickly available to any subscriber with internet access (including smart-phones).
Without using specific contractual language, comprehensive summaries inform subscribers of the extent of their contractual rights for in-network claims. NetworkDx analyzes and summarizes payors’ audit rights, usual and customary charge definitions, dispute resolution procedures, and miscellaneous provisions with a direct, user-friendly interface.
“Many benefit plans are bound by contracts they either don’t understand or have never seen. Examining the network agreements compiled by this new NetworkDx software makes a problematic task significantly less daunting,” explainsAdam V. Russo, Esq., Chief Executive Officer of The Phia Group, LLC. “Advanced Medical Strategies, a Massachusetts based firm, has taken advantage of our expertise and a decade’s worth of contractual review, and created a clear, concise, and useful feedback tool that users can access through on-line software.”
NetworkDx subscribers will be able to utilize the database to evaluate networks prior to signing a PPO contract; accessing NetworkDx’s review of applicable contract terms, without divulging any propriety information. Only NetworkDx offers this cross-network, convenient and comprehensive service with contract information added to the database regularly.
“Our clients, old and new, have supported AMS by subscribing to PredictDx; verifying their desire for innovative, data driven products based on real time claims experience. We couldn’t be more pleased to have developed NetworkDx with another excellent company, The Phia Group. We anticipate our clients will value NetworkDx and they can look forward to an even faster pace of innovation from us. We plan to introduce more useful new products to support them in their daily efforts to remain competitive and profitable,” states Peter Borans, President of Advanced Medical Strategies.
About Advanced Medical Strategies
Advanced Medical Strategies is a physician-lead organization bringing innovative solutions to the healthcare payor industry. Based in Lynnfield, MA, Advanced Medical Strategies has been offering world-class claims review and cost containment services since 2003. Contact Danae Lambeth, National Sales Director, at (781)-224-9711 x107,danae@mdstrat.com and visit www.mdstrat.com .
About The Phia Group
The Phia Group, LLC, headquartered in Braintree, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services designed to control health care costs and protect plan assets. The Phia Group’s overall mission is to reduce the cost of plans through its recovery strategies, innovative technologies, legal expertise, and focused, flexible customer service. Visitwww.phiagroup.com .
