Learn how to utilize 24/7 Healthcare Advocacy to streamline operations, increase customer service & retention and offer peace-of-mind to clients and plan members.
4. You and Your Team Face Increased
Responsibilities all while trying to
Deliver Significant Value
⢠Time tracking for variable hour employees
⢠Full-time employees and equivalents calculation
⢠Plan affordability analysis
ACA Reporting
⢠Data gathered automatically from payroll
⢠End-of-year printing and mailing to employees
⢠Completed employer forms filed with the IRS
Forms 1094 and 1095
⢠Penalty exposure warning
⢠What-if simulations
⢠Checklist to keep you on track
ACA Compliance
5. Todayâs Consumers have grown accustomed
to:
⢠Instant access to every piece of information.
⢠Expecting more services to be available 24/7.
⢠More comfortable connecting with people and businesses
technology instead of in person.
The Insurance Consumer has
Changed. Have you?
6. Move from Broker to Trusted Advisor
Stay on Top of
Legislation and
Industry Trends
Managing Healthcare
Timelines and Enrollment
Process
ACA and
Compliance
Checklist
7. Plan Members find Navigating Healthcare to be Very Confusing
Whatâs
Covered in
My Plan?
Mandatory
Second
Opinions
Scheduling
Appointments
Locating
Care
Providers
Brand or
Generic
Drugs?
In or
Out of
Network?
Finding
Convenient
Facilities
8. Supporting a Consumer requires a New Dimension of
Information and Solutions
What
should I do?
Where
should I go?
How much
will it cost?
Cost Transparency and
Medical Bill Review
Provider Search
and Scheduling
Evaluate and Compare
Treatment Options
$
9. We help with answers and get results.
⢠Help in understanding your health plan
⢠Find the Right Doctor, Hospital
⢠Schedule Tests, Appointments, Second Opinions
⢠Get cost estimates for procedures
⢠Resolve billing issues
⢠Perform medical record transfers
How does Healthcare Advocacy Help Members?
10. Assist your Clients with Cloud Based Collaboration of
Subject Matter Experts (SMEs)
13. General Plan Questions â˘
Assistance with Copayments, â˘
Deductible & Out-of-Pocket Costs
Clarify Covered Services â˘
Understanding Pharmacy â˘
Benefits & Formularies
PLAN BASICS:
Explanation &
Understanding Of
Benefits
⢠Finding In-Network Providers,
Treatments & Facilities
⢠Get Second Opinions & Alternative
Care Options
⢠Schedule Appointments & Transfer
Medical Records
⢠Compare Cost & Quality
FINDING CARE:
Transparency & Access
⢠Claims Explanation & Support
⢠Medical Bill Reviews & Audits
⢠Fee & Payment Negotiation
⢠Appeals & Approvals
PROBLEM
SOLVING:
Hands-On Support &
Solutions
Rx Medication Review â˘
Cost Savings Options â˘
Case Management Support â˘
One-to-One Preventative Care Planning â˘
PERSONAL CARE:
Individual Solutions
14. General Plan Questions â˘
Assistance with Copayments, â˘
Deductible & Out-of-Pocket Costs
Clarify Covered Services â˘
Understanding Pharmacy â˘
Benefits & Formularies
PLAN BASICS:
Explanation &
Understanding Of
Benefits
15. ⢠Finding In-Network Providers,
Treatments & Facilities
⢠Get Second Opinions & Alternative
Care Options
⢠Schedule Appointments & Transfer
Medical Records
⢠Compare Cost & Quality
FINDING CARE:
Transparency & Access
16. ⢠Claims Explanation & Support
⢠Medical Bill Reviews & Audits
⢠Fee & Payment Negotiation
⢠Appeals & Approvals
PROBLEM
SOLVING:
Hands-On Support &
Solutions
17. Rx Medication Review â˘
Cost Savings Options â˘
Case Management Support â˘
One-to-One Preventative Care Planning â˘
PERSONAL CARE:
Individual Solutions
18. Activity Summary Reports
⢠Employee / Member Count
⢠Number of Interactions
⢠Distribution of Call Categories
⢠Easy to Understand Usage Chart
Activity Reports Include
19. We answer the
phone 24/7 with
your agency name
and greeting.
We free up agency
staff to focus on
growing the
business.
We customize our
materials to
promote your
company and
brand.
We bring
value and improve
client retention and
relationships.
We provide
customized reports
that reinforce
program value.
Create a Differentiator
20. Become a Trusted Advisor
⢠Add Value and Enhance Client Relationships
⢠Improve Productivity and Retention
⢠Provide Expertise
⢠Stand Out in the Market
Healthcare. Confusion. Simplified.