THIRD PARTY ADMINISTRATION: CHALLENGES & OBJECTIVES
When a company decides to self insure, the issue quickly becomes who will play the role of operations administrator. Designing the benefit plan with your management and consulting team, presenting the plan to employees on behalf of the employer, while using care and your management philosophies is important. INDECS saved us millions of dollars – Chairman, NY School Districts Health ConsortiumPaying the claims properly, and answering the myriad of questions as employees try to navigate their course without incurring unneeded patient costs is a daunting task and requires a compatible attitude and experience, competent IT platforms, and people–oriented staff.
Insurance companies are equipped to do this, but often are busy building their own brand. So the company having them as a self insurance administrator gets pulled into their benefit format, their card, their documents and employee documents.
PROGRAM OVERVIEW
The selected administrator, INDECS, has been in business since the early 1980s. And they immediately went to work for Fortune 500 companies and met their high requirements for clear communication packages, friendly customer service and easy online availability of many kinds of reporting.
INDECS developed sophisticated IT platforms to support many different types of benefit plans. The corporate culture developed was one of support for their clients, not with a split agenda of developing their own brand. It was what they needed to do to continue in business.
Employers like INDECS because:
- Employers can get online data, selecting from reports on hundreds of different views of the experience;
- INDECS is operated as if an extension of your own company;
- Most claims are auto adjudicated, but with controls that allows them to identify suspect claims before they are paid.
Employees like INDECS because:
- Phones are answered by friendly people, not programmed messages that require navigation through unfamiliar terms;
- U.S. citizens are hired to do the jobs, but they must be multi-lingual to establish communications with all who call;
- Web access to search for providers with appropriate backgrounds and convenient locations;
- Online access to co-payments and deductible status, year-to-date claims payments. In contemplation of upcoming appointments, patients can get information about relevant medical conditions and even questions to ask the doctor to get the most out of each visit.
VALUE ADDED
Provides professional communications for employee and employer, from benefit documents to health care advice to employees. Guarantees administrative rates will not change for a three-year period.