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.
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.
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.