You’re not basic. Neither are we.
When it comes to self-funded benefits, your clients are looking for more than a cookie-cutter solution—something that is designed around their organization and people. As a tech-enabled TPA, we don’t believe in “bare minimum” services—we’re here for you and your clients throughout their healthcare journey.
We don’t go away after open enrollment. We’re helping your clients deliver a better healthcare experience to members using actionable analytics, insightful claims auditing and personalized educational resources.
Data & Cost Savings
We arm you and your clients with insightful data, customized reporting and innovative cost-containment strategies, including repricing management and reimbursement methods.
In-House Clinical Care
5% of employees drive 51% of healthcare costs. We connect people with targeted care management to help them stay on track and drive down costs.
Let’s work together to break out of a broken healthcare system.
Traditional healthcare models aren’t working for your clients or their members, leaving everyone suffering from the side effects of poorly-designed plans.
A cutting-edge solution for your clients.
We do things differently than old-school TPAs. Our self-funded solution is comprised of three core components: Administrative Services, Clinical Care Management and Cost Management. This allows us to build upon self-funded benefits basics and create the health plan that’s right for your employer clients.
From call support and education to claims management and stop-loss administration, we’ll handle all of the grunt work for your clients’ health plan.
Clinical Care Management
Not all members are the same. We’ll work with your clients’ people wherever they are on their healthcare journey, whether it be weight loss or managing a chronic condition.
Your clients have the ability to select their provider network partner(s), out-of-network repricing and how they want to manage their pharmacy benefits—we’ll take care of the rest.
Proof is in the data.
In 2019, we processed 500,000+ claims and paid out with 99.95% financial accuracy.
Your clients’ data—at no extra charge.
Unlike fully insured plans or working with other TPAs, we provide your clients with access to their claims data at no extra cost. We’ll work with you to create critical reports to help your clients understand what conditions are impacting their members and their bottom line.
A few benefits of Maestro Health Analytics:
- Gain visibility into health needs and cost of care for members
- See in-depth evaluations of high-cost claims and visits
- Find prescription drug savings
- Identify high-cost claims or admissions to initiate care management
- Compare your population with adjustable demographic benchmarks
- Analyze gaps in care and key quality metrics
Education and support every step of the way.
We believe all members should be educated on their health plan and have a positive, stress-free benefits experience. That’s why we offer all clients access to our full collection of educational materials—including flyers, our healthcare jargon dictionary, an educational microsite, videos and more—at no extra cost. As an added perk, we offer the option to co-brand these materials, so your clients’ member communications feel like them.
Let us help you.
The healthcare system is complicated enough. We’re here to make your job easier by providing your clients with a self-funded solution that lowers costs and improves health outcomes. Ready to learn more? Get in touch with us.