Catastrophic Care

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Optimum Strategy for Catastrophic Care Management

Our innovative business model dedicates a local Catastrophic Nurse Case Manager (NCM) to each case to conduct an assessment and recommend a plan of action to the Payor. All recommendations are presented to the client/Payor for authorization prior to execution of services through our care coordination team. This consultative and pro-active approach provides the optimum strategy for all parties involved, ensures timely intervention and cost management of high dollar exposure losses, and applies a best-practices approach for excess and reinsurance claim management.

Solutions to Address Industry Challenges

We have partnered with our clients to develop solutions to resolve the industry pain points.
Together we guide and provide clients with a catastrophic service model that enhances service integration, eases administrivative burden and reduces medical expenses 20% to 40% below retail rates.

INDUSTRY CHALLENGES

  • Coordinating services through multiple vendors
  • Lack of communication & fragmented service delivery
  • Lack of savings and administrative burden
  • Develop cost estimates and reserve accuracy
---> PCS SOLUTIONS

  • Single point of contact
  • In-house staffing model ensures seamless communication
  • National multi-line network with negotiated costs
  • Case assessment and full transparency

Our unique program includes the selection of regional service providers to ensure timely intervention and cost management of high dollar exposure losses at the pre and post excess and reinsurance retention levels.

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