11-Questions to ask your Group Insurance Company or Third Party Administrator

 

Having the right claim payer for your company’s healthcare program(s) will make a positive impact to your bottom line and employee productivity……………..

Published on July 5, 2017

By Michael Reagan, CBPA

Moving HealthCare Risk Management in a New Direction

Having the right claim payer for your company’s healthcare program(s) will make a positive impact to your bottom line and employee productivity.

  1. Does your claims administrator return 100% of unused funds? ABMS does!
  2. Does your claims administrator provide a “no-deficit-carry-forward” contract? ABMS does!
  3. Does your claims administrator allow you to view “real-time” claims activity? ABMS does
  4. What is the average turn-a-round time for processed claims by your claims administrator? ABMS’s average is 4 days!
  5. How quickly does your claims administrator answer the phone with a real person? ABMS’s average answer time is less than 10-seconds!
  6. What is the average accuracy of your claims administrator’s payments? ABMS’s is 99.6%! (could be higher….sometimes clients request exceptions)
  7. Who takes on Full Responsibility for all Hospital and Facility claims (not co-fiduciary for select claims) under a Reference Based Pricing contract?  ABMS’s RBR program does that!
  8. Who is contractually responsible for all hospital and facility appeals and billing disputes under your Reference Based Reimbursement contract? ABMS’s RBR program does that!
  9. Does your Pharmacy Benefit Manager save you an average of $300.00 per Specialty Drug medication in addition to discounted Average Wholesale Costs? ABMS does!
  10. Does your claims administrator give you a choice between the Cigna PPO network or Reference Based Reimbursement? ABMS does!
  11. Does your claims administrator provide you with a performance based guarantee? ABMS does!

Have your group healthcare insurance adviser contact us to find out if ABMS is the best choice for your claims administration.

Mike Reagan, CBPA, Regional Director, Advance Benefit Management Systems, Inc., mreagan@aimssc.com 214-850-1069 https://www.abmsusa.com/