.:: Plan Handlers ::.


Next	1	2	3	4	Back

An Important Service...Managing Your Money As If It Were Our Own

Since our inception, we have taken our role as the manager of your benefits expenditure very seriously. This means we bring to you a comprehensive portfolio of services and a team that will manage your plan to your financial goals. As a result, our trend rate has been roughly 50% of national averages in the last three years. Here is where we excel:

ThePlan Handlers has dedicated a team of resources to assist our clients in choosing the PPO Network(s) that provide the most effective balance of access and discounts. As your representative we cut through the facade of promised "discounts" to analyze contracts, re-price claims and check potential disruption to your employees. If appropriate, we are able to develop customized networks and have direct contracts in place with more than 400 hospitals and more than 25,000 physicians.

We maintain a partnership with a URAC-accredited (Utilization Review Accreditation Commission) medical management vendor that assists us in reviewing treatment plans and assessing the appropriateness of services and charges before and after a claim is submitted.

Our High Impact program uses sophisticated predictive modeling and risk assessment programs to identify covered participants with the greatest potential for incurring significant claims. We then help customize their treatment and self-management plans to minimize future high-dollar claims.

We utilize the RIMS claims administration system, recognized as a leader in benefit administration technology. The automation and controls provided by RIMS has allowed us to shift resources to enhance claims turnaround, accuracy and overall customer service.

Our ClaimsWatch program has been designed to ensure that we are fair in our processing, but have the controls in place to eliminate inappropriate expense. This includes:

Fully-integrated clinical edits, billing and "flags" applied to providers, patients, treatments, diagnoses and any other area of concern

On-site clinical resources

Application of sophisticated post-processing surveillance software and fraud detection software, plus use of a Special Investigations Unit (SIU) to monitor activity.

Aggressive pursuit of savings on all claims submitted from non-contracted providers. We have gained an average discount of 23% on more than 50% of the claims we pursued for a discount.

Unique electronic connections with vendors and procedures that enhance controls around Medicare, integration, coordination of benefits and third-party liability.

All in all, these programs save our clients $0.48 - $0.55 of every $1.00 billed by health care providers.

Newsroom | Careers | Health Tips & Links | Terms Of Use | Privacy Policy

One Civic Center Drive, Suite #350 -- San Marcos, CA 92069 -- Phone (800) 538-5512 -- Fax (760) 510-6300
© 2005 The Plan Handlers, Inc. All rights reserved. Terms Of Use Privacy Policy
Sales: Sales@planhandlers.com .....Web Master: Webmaster@planhandlers.com
Jobs : Jobs@planhandlers.com ... .. Fraud... .. ... : Fraud@planhandlers.com