Services

	Contract Review and Analysis Plan Document Review and Analysis Process/Procedure Analysis Research Work Flow Analysis
	Process/Procedure Analysis & Development Stop Loss Claim Disputes Department of Labor Claim Regulations Questionable Claims PPO Discount Disputes Service Issue Review/Resolution
	Market Analysis Pricing Strategy Profitability Analysis Stop Loss Carrier Analysis Vendor Analysis
	Due Diligence Reviews Legislative Interpretation & Operational Impact Plan Document Preparation & Analysis Service Agreement Development/Negotiations Training/Education

Can We Make A Difference in Your Business?

Why your organization should consider our services:

• Reduce your exposure to liability & risk.
• Reduce your expenses associated with resolving disputes.
• Increase your revenue opportunities through new product development .
• Retain your clients by improving & maintaining acceptable service levels.
• A complex and ever-changing regulatory environment.

Please consider the following questions to determine whether we can make a difference
in your organization.

1. The biggest challenge a third party administrator faces is the need to understand and follow the complex maze of government regulation, are you aware of the risks?
2. Are you losing clients due to service related issues?
3. Are you looking for opportunities to decrease your expenses?
4. Are you going to be changing claims platforms or preparing for a significant upgrade?
5. Have you attempted to launch a new product and failed?
6. Have you recently added a self-funded group health plan? If so, do you have one or more individuals guiding the project who have previous third party administration experience?
7. What are the most common reasons a third party administrator is involved in a dispute or litigation?
8. Have you ever made an exception to plan provisions? Do you understand the potential risk this may create?
9. Are you experiencing a large number of disputes, grievances or appeals?
10. Have you ever denied a claim because the stop loss carrier denied the claim?
11. Does the Department of Labor consider a TPA a fiduciary?
12. How does the Department of Labor view payments to a TPA?
13. Do you understand the reporting and disclosure requirements and who is responsible for the related duties?  Do you know what data you will be required to provide?