Third Party Administrators
Case Study
Administrative fees have fallen, and competitive pressures are keeping them down. Yet your clients are expecting even more services and greater cost-cutting assistance.
Health Decisions, Inc. offers products that can expand your services, grow your market, and increase your income without requiring any new technology or change in your claims-processing systems. We review claims after they are paid and report enrollment data to your specifications.
Third Party Administrators that use Health Decisions can build their business by:
- Enhancing the value of their claims payment service
- Increasing service and reporting capabilities
- Producing additional income opportunities
Because Health Decisions is at the cutting edge of technology we can help TPAs better deal with:
- The fallout of automated adjudication of claims
- fraud and abuse detection and prevention
- Medicare recovery
- identifying the best Continuous Quality Improvement (CQI) solution
- satisfying HIPAA and other regulatory requirements
Health Decisions Post Payment Administration system for payors includes emphasis on span of control, financial return, staffing, implementation, and CQI. Our suite of services covers data handling, data processing, case investigation, and case updates.
Health Decisions accepts claims data in almost any format and provides it to TPAs in Microsoft and web-compatible formats.