HealthSmart Insight
Integrated Health Plan for 50+ Employee Groups
HealthSmart Insight is our fully-integrated healthcare solutions for the self-funded employer. HealthSmart Insight includes several of our wholly-owned products bundled together for ultimate savings:
- Fully-Integrated Administrative Operating Platform for Claims, Voice and Data
- Examiners, Administrators & Customer Service Representatives With an Average Tenure of 6 Years
- Dedicated Account Management & Claims Examiners
- Automated Online Clinical Editing
- Complete Suite of Online Reporting & Analytics
- Out-of-Network Claims Negotiation Team
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- >Excellent Hospital & Physician Access
- Market-Leading Discounts
- Payment & Audit Guidelines Consistent With Carrier Guidelines, Including Out-of-Network
- Electronic Claims Processing – Submission, Remittance Advice & Fund Transfer
- Online Claim Status & Eligibility
- Dedicated Provider Relations Team
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- Care Management
- Utilization Review / Pre-Certification
- Large Case Management
- Managed Maternity Program
- Disease Management
- Predictive Modeling
- Transplant Management
- Health Advice Line (Demand Management)
- Health Assessments / Wellness Coaching
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- Nationwide Network With Over 60,000 Participating Pharmacies
- Brand Name, Generic & Mail Order Pricing
- Generic and Brand Formulary Options
- On-line Access To: Benefit & Eligibility Information, Accumulators & Out-of-Pocket Tracking and Claims History
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- Products Backed by Highly Rated Carriers
- Preferred Partners Who Have Evaluated HealthSmart’s Managed Care Tools
- Traditional Specific & Aggregate In All 50 States
- Our Partners Deliver the Most Competitively Priced Solutions In the Market
- Creative Solutions to Help Manage Our Client’s Risk
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