The premier provider of cost containment and document management software and service solutions in the workers compensation and auto liability industries. Medical innovations hit the market place so fast that even the best tpas with the latest adjudication software can benefit from the watchful eye offered by our physician advisors and registered nurse case managers. American healths medical cost containment provides a comprehensive solution for clients, verifying that charges billed are appropriate for the care provided. Identifying questionable charges that are incorrect, inconsistent, unjustified, coding errors, upcoding, unbundling errors or erroneous. Advanced medical pricing solutions amps provides market leading healthcare cost containment services for selffunded employers, public entities, municipalities, labor unions, brokers, consultants, tpas, payers, reinsurers, and hmos. Employers are driving a trend toward alternative medical cost management seeking reprieve from inflated medical pricing and ppo overpayment. An inhouse ebm software was developed in 2014 to achieve efficient and costeffective services for marm partners. Spero graduated medical school from the university of california, davis. Our mission is to deliver personalized representation and efficient, costconscious services with an emphasis on optimum medical outcomes. Excellent integration with claims systems, ppo and specialty.
Identifying questionable charges that are incorrect. Our mission is to deliver personalized representation and efficient, cost conscious services with an emphasis on optimum medical outcomes. Blueprint for workers comp cost containment product page. In the medical cost containment business, that is true for all. Leader in workers compensation cost containment and. Lower pharmaceutical costs and improve patients quality of life with our unique, threephase pharmacy intervention program. A uniquely qualified network ans medical and jurisdictional expertise, as well as a deepseated respect for physicians and genuine concern for injured workers wellbeing, allows us to achieve results you wont find anywhere else. While healthcare costs have risen dramatically over the past decade, cost containment organizations are successfully leveraging plexis proven payer platform to reduce the utilization and cost of unnecessary health services.
The awardwinning medical cost containment program of marm significantly reduces claims costs for its insurance and assistance clients, without compromising. Analyzing your medical data can be the first step in controlling those costs. Comptech medical management is one of the leaders in the workers compensation cost containment industry. Our cost containment software solutions empower the payer organizations with robust knowledge management and utilization of leading medicare benchmarking tools.
Developers seek profits and so are attracted to industries. We are compstar systems, a provider of medical cost containment software and services. Knowledgeable medical specialists, including registered nurses and physician advisors, along with state of the art software, help achieve maximum cost savings. Reduce net medical with our proprietary software and process.
They include international health and travel insurers and medical assistance companies based outside the uk. The application delivers a high level of fee schedule automation to maximize your workers compensation savings. Osp labs medical cost containment software solutions represent the interests of payers focusing on fraud detection, prevention, and overpayment recovery in. Containing the costs of health care can be useful to government, employer, and household budgets, but it may have a detrimental impact on innovation, since health care costs are the main source of revenue for medical innovators. Jonathan spero is the ceo of inhouse physicians and a thought leader in the area of cost containment solutions for selfinsured employers. By auditing medical accounts, ppo network administration, and ppo repricing, our healthcare cost management solutions automate and improve the claim cycle and transparency. The awardwinning medical cost containment program of marm significantly reduces claims costs for its insurance and assistance clients, without compromising the quality and efficiency of medical care that patients receive. Cost containment solutions uk and worldwide medical. One of the plans main purposes is to provide the necessary services and ensure that its members receive the proper treatment. Administering cost containment services payers leverage the plexis platform to successfully control expenses. Medical cost containment platform software medinyx. An opportunity to provide exceptional customer service, integrity, and leading edge technology. The premier provider of cost containment and document management software and service solutions in.
Each june, pwcs health research institute hri projects the growth of medical costs in the employer insurance market for the coming calendar year and identifies the leading factors expected to impact the trend. Willis risk control and claim advocacy practice rcca offers our. Orchid medical is a leading, nationwide ancillary healthcare services company specializing in medical cost containment for the workers compensation market. Penfield care, an international medical cost containment. Orchid medical is a leading, nationwide ancillary healthcare services company specializing in medical cost. Medical cost containment services rising medical solutions. Healthcare cost containment solutions 6 degrees health. Our solutions have been tailored and continue to evolve to ensure that our clients customers are receiving the right care medical management, at the right place i. Gmmis service provision stems from our comprehensive approach to medical cost containment and assistance services. Medical cost containment professionals, llc is a hybrid network that offers direct contracts as well as fee negotiation services. Our aggressive cost containment efforts have reduced bills by well over 50% in the last year.
World medical care is constantly evolving to ensure that our international clients have a complete set of leading solutions to manage the three universal fundamentals of. Willis risk control and claim advocacy practice medical. Novare was founded for the growing needs of employers and the insurance community seeking effective and responsible medical management services for injured workers. All bills are carefully evaluated by an our experienced team of claims professionals to determine whether. Cost containment with the plexis payer platform reduces utilization and unnecessary health services and costs across the board. Cost containment regulatory initiatives entail a balancing act of limiting the cost of services and inappropriate or unnecessary treatment without negatively affecting the quality of treatment or access to. Penfield care is an international medical cost containment and case management company specializing in domestic and international healthcare solutions.
Discover why intelligent medical solutions is the industry leader in cost containment. Our company was created because we saw an opportunity. Cost containment for payers plexis healthcare systems. The authors from the urban institute and health policy alternatives inc. The most important thing is always doing what is right. Health cost controls patient advocacy program plays a critical role in helping members and dependents with their healthcare costs. Population health management programs look at demographic and claims data to. Healthcare and benefit cost containment strategies and solutions for your.
It combines evidencebased analysis, inperson conversations, knowledgeable nurse experts, and an unprecedented followup protocol to impact real, meaningf. Penfield care, an international medical cost containment company. Healthcare cost containment solutions 6 degrees health, inc. Savings can be realized through medical managementcondition management, demand management, and case management. These initiatives aim to curb the cost of a particular service or to reduce the amount of services provided. He completed his residency in internal medicine from scripps mercy hospital in san diego and has practiced both internal and emergency medicine. Cost containment programs can also be implemented in the medical plan. Willis risk control and claim advocacy practice medical cost containment solutions businesses are challenged every day to control the cost of workers compensation and to improve their bottom lines. Whether you are seeking to overhaul your own workers compensation program or help a client finetune an already effective program, blueprint for workers comp cost containment gives you insight and solutions for controlling or even reducing workers compensation costs and premiums. The colorado cost containment certification board requires a safety and cost containment program that complies with criteria outlined in state statute.
A diverse range of client organisations utilise our uk medical assistance and cost containment solutions. The premier provider of software and service solutions for insurance carriers, selfinsured companies, thirdparty administrators, state funds and public entities in the workers compensation and auto liability industries. We provide a variety of services for individuals, self insured trust. Maritime medical cost containment if you are not using future cares medical audit and cost containment services, you likely are paying more than you should for your crew medical costs. Medlinks cost containment is a resource for medical professional instititions to outsource their billing, abstracting, auditing, coding, and staffing. Medical cost containment professionals, llc preferred.
Medical services and procedures are documented properly. Health care cost containment and medical innovation aspe. We continually develop, test, and implement new solutions to meet the ever changing needs of our clients. Ims represents the culmination of over 60 years experience within the cost containment industry. Our medivi platform provides valuable medical reimbursement analytics for audits, contracting, claim negotiation, and referencebased pricing. Employee healthcare cost containment a strategy that works. This unique approach begins with a thorough assessment of prepaid claims by our internal experts. It gathers, sorts, and organizes the data from millions. Medical innovations hit the market place so fast that even the best tpas with the latest adjudication software can benefit from the. Smart controls, a well thought out strategy and other cost containment tools can result in better care and.
Smart controls, a well thought out strategy and other cost containment tools can result in better care and better outcomes for your employees, while significantly lowering costs for all. Artifical intelligence when incorporated in management platforms can analyse the data input related to all procedures which can later be tracked an compared easily. Strataware is bestfit software built for cost containment. Cost containment has long been a concern of hospitals and the american hospital association aha. In the medical cost containment business, that is true for all three important sides of the triangle. An opportunity to help our clients by providing solutions, increasing productivity, and lowering costs.
As a pioneer in the wc market for implants cost management, our surgical cost containment program sccp makes us one of the only providers who delivers a holistic approach to surgical cost containment. Integrated medical cost containment management business. A formal declaration of a companywide safety policy. Cost containment definition of cost containment by medical. The hospitals and ahas activities in cost containment fall into four major categories. Workers compensation large deductible and selfinsured programs through our medical cost containment analysis, a proprietary process developed by our. Pcg works with healthcare payer and provider organizations to increase profitability by enhancing cost containment, maximizing financial recoveries, and significantly reducing fraud and abuse. Cost containment for workers compensation conduent. Heading into 2020, medical cost trend is expected to increase slightly. The medivi software platform is an industryleading source of transparent hospital financial and quality data. Robert berenson, michael hash, thomas ault, beth fuchs, stephanie maxwell, lisa potetz and stephen zuckerman wrote this report for the aarp public policy institute. In recent years, however, cost containment has assumed a special prominence in hospitals, becoming both a political and social necessity. With over 150,000 providers agreeing to work with us on a their out of network claims, we can capture greater savings for our clients no matter the size of the claim.
Data analytic driven medical cost containment solutions managed care, workers compensation, general liability proven track record results delivered our services are customized for you hcrg specializes in medical cost containment solutions across the nation. National provider of medical cost containment solutions through a unique business model that delivers innovative, integrated, and flexible services focused to improve healthcare management and costs long history providing customized integrated cost containment service programs specifically to the workers compensation, auto. The october issue features articles on addressing the sdoh impact on readmissions, valuating the cost benefit of medical technology, reducing healthcareassociated infections and assessing clinical costs. Leader in workers compensation cost containment and medical. Willis risk control and claim advocacy practice medical cost. Healthcare cost containment healthcare cost management. Self funded medical insurance cost containment strategies. World medical care is constantly evolving to ensure that our international clients have a complete set of leading solutions to manage the three universal fundamentals of healthcare.