Physician Costs

Reducing Claim Spend

Physician Costs

Physician costs can be mitigated. With providers feeling the squeeze on Medicare and Medicaid reimbursements it is imperative to minimize any cost shifting to employer-sponsored plans. Combined with the coding review platforms (ARM™ and ARMOR™) to protect the plan from being overcharged, we help plan sponsors identify ways to:

  • Make accessing care easy and cost effective to both the member and the plan.
  • Potentially capture 75% of primary care expenses as a fixed cost, paying providers and staff hourly.
  • Engage employee in decision of specialty selection by providing usable information that is specifically based on his/her direct costs (considering their deductible, coinsurance and out of pocket), as well as the outcomes of each provider being considered.
  • Integrate and manage a comprehensive wellness program; claim costs can be reduced over $1,500 per employee per year with a well managed campaign.
  • Improve compliance – making sure member takes prescriptions and receives appropriate care.
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