COST SAVINGS

How We Save Money for Our Clients

Saving time: Every hour spent struggling with health and benefits issues is lost time at work. Our advocates allow your benefits staff to focus instead on plan design, managing vendors, and devising strategies to reduce benefit costs. Individual clients gain peace of mind and time to focus on family support and other important issues.

Changing behavior: We coach the 20 percent of your workforce who generate 80 percent of your health plan costs on how to use wellness, employee assistance, disease management and other services to stay healthy and productive.

Choosing the right plans: During Annual Enrollment, we help employees choose plans and doctors wisely. Before enrollment, we make sure desired providers are in the network and that the coverage selected best matches the employees' and dependents' needs. Many employees elect dual coverage because of fears about job loss but we explain how family status changes protect them and encourage them to select only one plan. We also encourage enrollment in flexible spending accounts; it not only reduces individual income taxes due but also corporate payroll taxes.

Correcting billing errors: Billing errors by hospitals, labs or doctors or overcharges above plan guidelines can add up to thousands. We avoid those extra costs by diligently checking disputed claims so plans only pay the right amount for the right sevices. We recently saved a client nearly $100,000 when we realized the providers had billed more than the allowable amount.

Screening providers before treatment: We help employees who call us before treatment avoid issues with out-of-network providers and take advantage of large in-network discounts. We focus equally on quality — identifying the doctors and hospitals with the best outcomes and fewest complications for the illness or condition. Individual clients facing major medical decisions can avoid costly headaches later through the same diligence.

Pricing before buying: By reviewing coverage before such costly procedures as MRIs and PET Scans and determining the best prices, we empower employees to make better choices. It's a particularly effective strategy to reduce costs since outpatient diagnostics are one of the fastest-growing medical plan expenses. Individuals also benefit since few have the time to discover even significant regional differences that can exist for the same test or procedure.

Removing barriers: More employers are moving to consumer-driven health care plans, but many employees still don't like or use them properly because they don't understand how they work. We clearly explain the plans and their benefits and coach employees in their use — removing this significant barrier to cost-efficient, high-quality care. We can be a resource to individuals with the same questions.