A commitment to conserving plan assets.
In a healthcare marketplace where costs and complexity grow daily, it is critical to identify and utilize all available cost-containment strategies. Beacon, either directly or through its relationships with trusted partners, works with the plan and its claims administrator to conserve plan assets through a variety of proven strategies.
- Out-of-network provider negotiations and repricing. Beacon works on the plan's behalf to negotiate a wide variety of bills ranging from home health and durable medical equipment to transplant-fee negotiation. This can be done on a proactive or retroactive basis.
- Bill review/audit services. These services can include usual and customary charge audits, billing error audits and complete hospital bill audits. Assistance with provider appeals and settlements is also provided.
- Physician review and peer-to-peer consultation. This can occur on a concurrent or retrospective basis and includes all medical specialties. Our physician partners can work independently or in concert with the plan's medical management provider and claims administrator to address medical necessity and length-of-stay concerns, experimental/investigational issues and quality of care.
- Customized Catastrophic Case Management Programs. These programs are individually tailored to the plan's needs and requirements, and provide ongoing management of serious illness or injury by coordinating appropriate, cost-effective treatment. Registered nurses or physicians who are experienced and knowledgeable regarding clinical specialties and alternative resources provide these services. Beacon's case-management partners facilitate communication between the claimant, healthcare providers and claims administrators. While advocating for the claimant, the case manager helps maximize available benefits by coordinating appropriate utilization of medical care, assessment of alternative resources and fee negotiation.
- Access to specialty networks. Beacon offers access to "centers of excellence" providers for a wide variety of illnesses including transplants, traumas, congenital heart defects, dialysis, and cancer.
A self-funded plan can utilize these services in conjunction with their Beacon Risk Strategies stop loss program or as a stand-alone program. We invite you to contact us at claims@beaconrisk.com to see how we can assist you.
