On Attention to Detail— “You were on top of everything, and I just want you to know how appreciated it is.”

Employee Health Plans

Efficient Benefits Administration

Employers often can save money and run more-effective health care plans through self insurance. However, to make this option work, the organization needs a partner who understands the complexities, pitfalls and opportunities that characterize today’s health care system.

Patient Advocates has the experience, work ethic and skilled staff to carefully and effectively provide third-party benefits administration to self-insured organizations. Our services include:

  • Claims Administration
    • Claim Edit System
    • Integrated Claims Software FACTS SERVICES
    • Provider Fee Schedules
    • Provider Network Participation
    • Subrogation
    • Captiva (ADP) Reasonable & Customary Profiles
    • Ingenix Claim Edit System (CES)
  • Eligibility & Enrollment Services
  • COBRA/HIPAA Management
  • Section 125/FSA Administration
  • Health Reimbursement Arrangements
  • Network Access Integration
  • Pharmacy Benefits Management Integration
  • Plan Document and SPD Preparation
  • Integrated Reporting Suite

In addition, we provide reports that analyze plan performance related to topics such as per-claimant cost, per-benefit cost, high-risk claimants, top providers and payments by benefit categories. Patient Advocates designs a personalized reporting package to meet the needs of individual organizations, making sure that there’s a full understand what reports will be used and their frequency.

Because Patient Advocates both administers plans and provides wellness services, we have the unique ability to determine a return on investment for that program. These reports show you how quickly your investment in employee wellness starts to pay dividends.

If you are looking for a partner you can trust to administer your self-insurance health plan, think of Patient Advocates at (800) 290-8559.