Transcription of Payer Solutions - Center Care Health Benefits …
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Payer Solutions - Center Care Health Benefits …
Payer Solutions Active Accounts For Health Care Professionals Updated September 2013. We contract with Third Party Administrators (TPAs) to share the administration of self -funded (ASO) plans. We also contract with several insurance companies that issue individual and group insurance policies. For these relationships, we provide access to our network, perform medical management and utilization reviews, re-price claims according to our contracted rates and claims logic, provide clinical appeals management, and provide contract dispute resolution. For some clients, we may also provide transplant and out-of-network discount programs, stop loss insurance, disease management services, or pharmacy Benefits . Third party administrators and insurance companies maintain eligibility, administer Benefits , and pay claims for these shared accounts on their own systems. You may also find the following information helpful in understanding how these plans are managed: We require our TPA partners to frequently provide eligibility information.
We contract with Third Party Administrators (TPAs) to share the administration of self-funded (ASO) plans. We also contract with several insurance companies that issue individual and group insurance policies.
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