By auditing medical accounts, ppo network administration, and ppo repricing, our healthcare cost management solutions automate and improve the claim cycle and transparency. In the medical cost containment business, that is true for all. The awardwinning medical cost containment program of marm significantly reduces claims costs for its insurance and assistance clients, without compromising the quality and efficiency of medical care that patients receive. It gathers, sorts, and organizes the data from millions. The premier provider of cost containment and document management software and service solutions in the workers compensation and auto liability industries. Strataware is bestfit software built for cost containment. Health cost controls patient advocacy program plays a critical role in helping members and dependents with their healthcare costs.
The hospitals and ahas activities in cost containment fall into four major categories. Identifying questionable charges that are incorrect, inconsistent, unjustified, coding errors, upcoding, unbundling errors or erroneous. Willis risk control and claim advocacy practice medical cost. The premier provider of cost containment and document management software and service solutions in. Whether you are seeking to overhaul your own workers compensation program or help a client finetune an already effective program, blueprint for workers comp cost containment gives you insight and solutions for controlling or even reducing workers compensation costs and premiums. In the medical cost containment business, that is true for all three important sides of the triangle. He completed his residency in internal medicine from scripps mercy hospital in san diego and has practiced both internal and emergency medicine. Heading into 2020, medical cost trend is expected to increase slightly. This unique approach begins with a thorough assessment of prepaid claims by our internal experts. Integrated medical cost containment management business. Analyzing your medical data can be the first step in controlling those costs. Medical innovations hit the market place so fast that even the best tpas with the latest adjudication software can benefit from the watchful eye offered by our physician advisors and registered nurse case managers.
Lower pharmaceutical costs and improve patients quality of life with our unique, threephase pharmacy intervention program. Reduce net medical with our proprietary software and process. Healthcare cost containment solutions 6 degrees health. Smart controls, a well thought out strategy and other cost containment tools can result in better care and better outcomes for your employees, while significantly lowering costs for all. Spero graduated medical school from the university of california, davis. We provide a variety of services for individuals, self insured trust. Cost containment regulatory initiatives entail a balancing act of limiting the cost of services and inappropriate or unnecessary treatment without negatively affecting the quality of treatment or access to. A diverse range of client organisations utilise our uk medical assistance and cost containment solutions. The medivi software platform is an industryleading source of transparent hospital financial and quality data. Robert berenson, michael hash, thomas ault, beth fuchs, stephanie maxwell, lisa potetz and stephen zuckerman wrote this report for the aarp public policy institute. We are compstar systems, a provider of medical cost containment software and services.
Employers are driving a trend toward alternative medical cost management seeking reprieve from inflated medical pricing and ppo overpayment. National provider of medical cost containment solutions through a unique business model that delivers innovative, integrated, and flexible services focused to improve healthcare management and costs long history providing customized integrated cost containment service programs specifically to the workers compensation, auto. A uniquely qualified network ans medical and jurisdictional expertise, as well as a deepseated respect for physicians and genuine concern for injured workers wellbeing, allows us to achieve results you wont find anywhere else. As a pioneer in the wc market for implants cost management, our surgical cost containment program sccp makes us one of the only providers who delivers a holistic approach to surgical cost containment. Identifying questionable charges that are incorrect. Medlinks cost containment is a resource for medical professional instititions to outsource their billing, abstracting, auditing, coding, and staffing. Medical cost containment services rising medical solutions. Willis risk control and claim advocacy practice medical cost containment solutions businesses are challenged every day to control the cost of workers compensation and to improve their bottom lines. Workers compensation large deductible and selfinsured programs through our medical cost containment analysis, a proprietary process developed by our. Our cost containment software solutions empower the payer organizations with robust knowledge management and utilization of leading medicare benchmarking tools. The application delivers a high level of fee schedule automation to maximize your workers compensation savings.
We continually develop, test, and implement new solutions to meet the ever changing needs of our clients. Penfield care, an international medical cost containment. An inhouse ebm software was developed in 2014 to achieve efficient and costeffective services for marm partners. Cost containment for workers compensation conduent. While healthcare costs have risen dramatically over the past decade, cost containment organizations are successfully leveraging plexis proven payer platform to reduce the utilization and cost of unnecessary health services.
Our medivi platform provides valuable medical reimbursement analytics for audits, contracting, claim negotiation, and referencebased pricing. Containing the costs of health care can be useful to government, employer, and household budgets, but it may have a detrimental impact on innovation, since health care costs are the main source of revenue for medical innovators. Smart controls, a well thought out strategy and other cost containment tools can result in better care and. Medical services and procedures are documented properly. The awardwinning medical cost containment program of marm significantly reduces claims costs for its insurance and assistance clients, without compromising. These initiatives aim to curb the cost of a particular service or to reduce the amount of services provided. Medical cost containment professionals, llc preferred. Healthcare and benefit cost containment strategies and solutions for your.
Cost containment for payers plexis healthcare systems. Artifical intelligence when incorporated in management platforms can analyse the data input related to all procedures which can later be tracked an compared easily. Penfield care is an international medical cost containment and case management company specializing in domestic and international healthcare solutions. Discover why intelligent medical solutions is the industry leader in cost containment. Gmmis service provision stems from our comprehensive approach to medical cost containment and assistance services. The most important thing is always doing what is right. A formal declaration of a companywide safety policy. World medical care is constantly evolving to ensure that our international clients have a complete set of leading solutions to manage the three universal fundamentals of. Pcg works with healthcare payer and provider organizations to increase profitability by enhancing cost containment, maximizing financial recoveries, and significantly reducing fraud and abuse.
Novare was founded for the growing needs of employers and the insurance community seeking effective and responsible medical management services for injured workers. The premier provider of software and service solutions for insurance carriers, selfinsured companies, thirdparty administrators, state funds and public entities in the workers compensation and auto liability industries. The colorado cost containment certification board requires a safety and cost containment program that complies with criteria outlined in state statute. It combines evidencebased analysis, inperson conversations, knowledgeable nurse experts, and an unprecedented followup protocol to impact real, meaningf. One of the plans main purposes is to provide the necessary services and ensure that its members receive the proper treatment. The october issue features articles on addressing the sdoh impact on readmissions, valuating the cost benefit of medical technology, reducing healthcareassociated infections and assessing clinical costs. Healthcare cost containment solutions 6 degrees health, inc. Our solutions have been tailored and continue to evolve to ensure that our clients customers are receiving the right care medical management, at the right place i.
Orchid medical is a leading, nationwide ancillary healthcare services company specializing in medical cost containment for the workers compensation market. Our company was created because we saw an opportunity. An opportunity to help our clients by providing solutions, increasing productivity, and lowering costs. Data analytic driven medical cost containment solutions managed care, workers compensation, general liability proven track record results delivered our services are customized for you hcrg specializes in medical cost containment solutions across the nation.
Knowledgeable medical specialists, including registered nurses and physician advisors, along with state of the art software, help achieve maximum cost savings. Penfield care, an international medical cost containment company. Population health management programs look at demographic and claims data to. Each june, pwcs health research institute hri projects the growth of medical costs in the employer insurance market for the coming calendar year and identifies the leading factors expected to impact the trend. Ims represents the culmination of over 60 years experience within the cost containment industry. Healthcare cost containment healthcare cost management. Excellent integration with claims systems, ppo and specialty. Cost containment solutions uk and worldwide medical. In recent years, however, cost containment has assumed a special prominence in hospitals, becoming both a political and social necessity. Our aggressive cost containment efforts have reduced bills by well over 50% in the last year.
Comptech medical management is one of the leaders in the workers compensation cost containment industry. Willis risk control and claim advocacy practice medical. Administering cost containment services payers leverage the plexis platform to successfully control expenses. They include international health and travel insurers and medical assistance companies based outside the uk. Maritime medical cost containment if you are not using future cares medical audit and cost containment services, you likely are paying more than you should for your crew medical costs. Cost containment with the plexis payer platform reduces utilization and unnecessary health services and costs across the board. Osp labs medical cost containment software solutions represent the interests of payers focusing on fraud detection, prevention, and overpayment recovery in. Leader in workers compensation cost containment and medical. Cost containment programs can also be implemented in the medical plan. Willis risk control and claim advocacy practice rcca offers our. Health care cost containment and medical innovation aspe. Medical cost containment platform software medinyx. Medical innovations hit the market place so fast that even the best tpas with the latest adjudication software can benefit from the.
Blueprint for workers comp cost containment product page. The authors from the urban institute and health policy alternatives inc. Medical cost containment professionals, llc is a hybrid network that offers direct contracts as well as fee negotiation services. With over 150,000 providers agreeing to work with us on a their out of network claims, we can capture greater savings for our clients no matter the size of the claim. Cost containment has long been a concern of hospitals and the american hospital association aha. Orchid medical is a leading, nationwide ancillary healthcare services company specializing in medical cost. American healths medical cost containment provides a comprehensive solution for clients, verifying that charges billed are appropriate for the care provided. World medical care is constantly evolving to ensure that our international clients have a complete set of leading solutions to manage the three universal fundamentals of healthcare. Self funded medical insurance cost containment strategies. All bills are carefully evaluated by an our experienced team of claims professionals to determine whether. Our mission is to deliver personalized representation and efficient, cost conscious services with an emphasis on optimum medical outcomes.
535 1023 206 1347 758 1123 1211 777 651 295 1658 693 823 24 806 365 1353 1307 723 196 108 1054 39 31 892 1318 636 1175 574 255 1166 987 321 993 173 70