Health
Cost Solutions Products and Services
Imagine
entering a vast file room where your most important
health benefit plan cost data is stored – during
a blackout. All the answers to your concerns and questions
are there, but all you have to light your way is a
tiny, dim penlight that has been in the back of a drawer
in your desk for the past two years. It illuminates
a small amount of information at a time, and isn’t
very useful to find data located in another section
of the room. Now imagine the power is restored and
bright fluorescent tubes bathe the entire room in a
brilliant light.
That describes the difference between
Health Cost Solutions’ data
integration foundation and that provided by health
network providers or claims services.
Health Cost Solutions
harnesses the power of computing technology to leverage
its efforts on behalf of its
clients. For each client, we develop a customized data
warehouse, and capture
the complex set of rules that govern a health benefit
plan.
By integrating and correlating information from
multiple sources within a plan’s “data
chain”,
we are able to bring together a composite of all the
relevant information in a way that may not have been
available to the sponsor before. This organizational
format allows us to systematically find the “needles
in the haystack” of potential errors for recovery
and provides a basis for further analysis and reporting.
Integrated Suite of Comprehensive Services
The most
common needs of health benefit plan managers are:
- Determine
if our plan is “leaking” money,
and if it is, help us recover it
- Determine
cost-effective ways for us to eliminate these leaks
in the future (reactive)
- Determine other cost effective ways for
us to eliminate excess costs in the future (proactive)
- Provide customized
reporting to help us answer the questions that
will allow us to manage
our plan costs
more effectively
Focused
Services
We offer the services that would compose a
comprehensive engagement on an individual basis. In
each case, the
services are based on a customized data warehouse of
claims, eligibility, plan rules and vendor provisions.
Some sponsors’ decision making may have only
gone only as far as deciding to conduct an audit. Perhaps
other sponsors are more focused on reducing future
costs. To meet the needs of such plan sponsors we also
offer our services on a more focused basis |
