SELF FUNDING SERVICES
Self-Funding Services
As a third-party administrator, we work closely with you to design an optimal, customized benefits package.
Reference-Based Repricing
Referenced-based repricing is designed to encourage healthcare plans to pay the provider a fair rate, without unduly restricting benefits.
Cost-Reduction Solutions
Discover the cost-reduction solutions that offer a significant improvement in savings without compromising quality of care.
PRODUCTS AND SERVICES
Stop Loss
We work closely with each client to carefully and properly assess individual risk exposure and tolerance level.
Teaming with carriers equally committed to stop-loss efforts ensures that our clients receive the most competitive stop-loss rates available.
Protecting our clients against catastrophic medical expenses that exceed anticipated amounts via aggregate stop loss initiatives.
Medical Cost Containment
We implement an important set of strategies and tools to reduce benefits costs for all clients.
Our medical bill review system is carefully designed to detect and alert us to billing errors to ensure that unnecessary costs are not only corrected but avoided.
Upon detection, claims are audited and adjusted accordingly saving our clients unnecessary expense burdens within their selected healthcare plans.
Pharmacy Solutions
AdminOne understands that medication costs continue to increase faster than other health care expenditures and that controlling these costs is critical to a sustainable healthcare strategy.
Through our pharmacy benefit affiliates we assist in exploring unique and flexible pharmacy benefit plan options that include discount plans and generic prescription utilization.
HIPAA & Cobra
We offer claims review for prior coverage when potential pre-existing claims arise.
Our full service includes verification of coverage, providing HIPAA certificates, monthly report provisions, return check processing, timely payment assurance and Cobra compliance management.
Care Management Solutions
Specialized care is a necessity for many of our clients at one time or another, and for some on a continual basis. These integrated programs ensure that our clients get what they need when the need it while avoiding unnecessary expenses.
With effective care management we improve disease control, reduce the stress that can accompany self – management, prevent admissions and re-admissions and improve the coordination of care for all patients.
Dental & Vision Administration
We are here to help connect our members with the dental and vision benefits most compatible with their chosen health care coverage.
We work with many dental networks and vision care specialists to ensure ample options when locating and selecting participating providers.
We offer additional assistance with out-of-network claims processing.
HSA/HRA/FSA
We work with a range of health savings account providers to assist individuals in better managing their health care costs.
Health Saving Accounts offer several benefits, not only spending for the short term, but also saving for longer term qualified expenses including those in retirement.
HSA funds may be used to pay for qualified medical expenses at any time without federal tax liability or penalty.
