Patient Advocates, LLC (PA), is a privately held Maine owned company that manages employer sponsored health and welfare plans. PA provides health care, employee benefit and risk management services with specialized expertise in administering; designing and managing employer sponsored health plans. PA’s client services are based on over twenty five years’ experience in the development and operation of managed health care, fully insured benefit plans and self insurance services on behalf of many of Maine’s largest and most prominent employers. PA brings to its clients a track record of successful, cutting edge administrative and care management techniques derived from an in depth experience with the internal operations of claims administration and managed care services.

Principals of Patient Advocates, LLC

In 1983, James Ward, President of Patient Advocates, LLC, developed the state’s first managed care company whose unique techniques of successfully managing health care through patient advocacy have properly positioned its clients for the emerging national issue of patients’ rights. In 1985, Mr. Ward started the state’s first preferred provider organization, Maine Health Plan, which also provided third party claims services. In 1995 Blue Cross and Blue Shield of Maine acquired both companies.

In 1995 Patient Advocates began providing ERISA auditing, “centers of medical excellence” network development and risk management services to northern New England employers. These services were offered as unique and appropriate alternatives to those of the traditional insurance establishment.

PA’s “hands on” operating methods are key to its success. PA works closely with clients and their brokers to:

• Acquire an in depth understanding of the each client’s culture, perceived needs and objectives
• Develop short and long term strategies to provide quality, cost effective health care for their employees and family members
• Define client specific objectives and measures of success
• Monitor frequently, and in great detail, operations of the various aspects of the client’s health plan to assure that desired results are achieved
• Provide for as much client involvement and control over the process as desired

The following features differentiate PA and its services from traditional managed care companies and third party administrators:

Customer Focused Administrative Services
Customer service is paramount at PA. Our clients, their employees and covered family members are our first priority.

Commitment to Measured Results
PA is committed to the highest levels of quality and client satisfaction. We stand behind our performance with guarantees and welcome your feedback.

Strategic Relationships
PA has underwriting relationships with national reinsurance and excess loss companies, including the country’s largest HMO underwriter. In addition to staying on the cutting edge of health care risk financing and management, PA has worked with one of its leading risk partners to develop a national medical “centers of excellence” network for its clients. As a result, covered employees and family members of our clients will have better access to leading medical centers across the country for the treatment of serious illnesses and injuries. In addition, PA has similar arrangements with certain Maine based health care providers to develop cutting edge pricing and patient oriented health systems

The rapidly evolving health care system and the resultant challenges to employee health plans requires, like many other services today, specialized expertise and nontraditional approaches. An employer’s health plan today must address a complex set of issues. They are:

• Adaptability
• Flexibility
• Pricing of component parts
• Performance of component parts
• Cost effective medical care
• Employee medical needs
• Freedom of choice of health care providers

Moreover, the administration and management of an employer sponsored benefit plan should always have a vision for the future as the health care system enters a more rapidly evolving phase of a long term radical restructuring.

James A. Ward, President

President and principal of Patient Advocates, Mr. Ward is a graduate of the University of Maine and Boston College School of Law. Mr. Ward has over twenty-five years of experience in providing risk management services to some of Maine’s most prominent employers. His prior experience included six years with an international consulting firm with the last three years as Vice President. Having owned and operated one of the most successful third party claims administrators in northern New England, as well as starting the state’s first two Maine owned managed health care companies, Mr. Ward understands the critical underlying operations necessary to provide the proper mix of claims management and employee services.

Mr. Ward’s role is to develop and maintain a working partnership with clients as well as nurture networking and bench marking among them. Clients can expect frequent contact and immediate access.

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