At Integrated Plans we appreciate the opportunity to present our programs to assist you in the prediction and administration of the medical benefits
Integrated Plans offers the opportunity for your company to benefit from our experience and our development through many new programs that will reduce your clients cost and educate their employees to become better purchasers of Healthcare.
Integrated Plans prefers to manage small to medium sized employer groups, (50 to 5000). We use a consultative model of employment in order to control the cost for the employer groups whom we work.
Integrated Plans provides a variety of services tailored to the specific needs of the employer groups, their employees and participating dependents.
We would like to show you how you can stabilize their healthcare cost increases
- How we can educate their employees and dependents to be wiser purchasers and utilizers of healthcare
- How we can bring a higher level of healthcare quality for consumers and at the same time manage your client’s costs
- How can we replace the existing fragmented and inefficient medical benefit management process and help the employer provide better healthcare to their employees and their employees participating dependents
- How we can limit the financial impact of high dollar medical claims through diligent review of documentation and the ability to use the discovery associated with that review to negotiate accurate and fair reimbursement that will stand up to legal scrutiny
Integrated Medical Benefit Management Program
We will go into important details that will help define current programs that Integrated Plans can improve in order for your company and employees to receive the best care and lowest claims to help budget for more beneficial aspects.
Why medical benefit management today is a dangerously fragmented process.
There is No Communication between the multiple companies responsible for managing the care and medical benefits of the employee! Multiple companies perform different aspects of the medical benefit management task. One company provides prior authorization and possibly utilization review, while another performs large case management and yet another performs concurrent review, discharge management and yet another provides transitional care if transitional care is offered at all! Another company provides disease management and yet another provides predictive analytics. Integrated Plans provides all of these services and does so using one integrated staff who in proximity to ensure the patient’s care is really managed and the best possible medical outcome is achieved at the best price, without sacrificing quality.
Integrated Plans provides the best processes for medical benefit management programs.
In performing prior authorization and utilization management many other companies stop after medical necessity is determined. That is little more than a administrative function and frequently not performed by a nurse. Integrated Plans prior authorization and utilization management staff considers the determination of the medical necessity the point where our work begins.
Most referrals result in a visit to a specialist physician or the authorization of a short term service like home health that will assist in the patient’s recovery from an acute onset of a common disease like an upper respiratory infection or an injury like a sprained ankle or a strain of a component of the Musculo-skeletal area like the back. These are important events to the patient but do not require onsite management and oversight by our team. We track these referrals carefully, but rarely need to intervene in the patient’s course of treatment.
Other referrals however may indicate the beginning evaluation of chronic disease or more serious injuries that may require a more extensive treatment for the patient and additional scrutiny by our staff. These events are tracked to ensure the treatment regimen implemented results in the best medical outcome for the patient. This attention to detail is what separates Integrated Plans from our competitors.
Prior authorization and utilization review are but one example of our unique Medical Benefit Management Programs. Integrated Plans services are available to view in order to determine if our company is the right fit for your client. We believe your employees and their family members will benefit greatly from the work we do at Integrated Plans.