Health Benefit Services
Employee benefit programs play an important role in attracting
great people and keeping them happy. However, as the cost of providing
health benefit plans escalates, employers struggle to keep the
programs competitive and to control expenses.
TRISURANT can help . . .
We offer Wellness, Lifestyle Management, and Disease Management
programs. Our on-site clinics can be implemented in a variety
of cost-effective ways. We provide access to a PBM with an alternative,
transparent model and guaranteed pricing that passes 100% of the
prescription drug rebates and the pharmacy network discounts for
brand and generic drugs at both retail and mail distribution channels
to the employer. It even offers a unique alternative to the mail
order program, available locally at over 30,000 pharmacies. In
addition, we provide flexible health payment options through FSAs,
HRAs, HSAs.
Health Benefit Services
TriSurant's Health Benefit Services division provides a fully
integrated portfolio of services. We categorize our programs and
services into four main topics:
- Population Management (to prevent claims
or reduce their severity),
- Utilization Review and Case Management (to
coordinate quality medical care and contain cost),
- Claims Management (to pay appropriate claims),
and
- Reporting and Analysis (to assess results
and forecast cost trends)
Population Management
services include wellness programs, lifestyle management tools
and disease management programs. We are able to provide these
services for clients that have local, regional and national operations.
Onsite clinics put medical professionals in employer locations
to provide quick and easy access by employees for a wide range
of services.
Our company has delivered Utilization
Review and Case Management services since 1985.
In 1993, our Medical Services department obtained certification
as a UR Agent from the State of Texas. Our on staff nurses provide
case management services to optimize patient care and coordinate
activities and referrals to and from the disease management program.
Claims Management
encompasses not only the work of our experienced claims examiners
utilizing our claims processing system but also it can be integrated
with loss control, fraud detection, and decision support software.
The software includes an integrated data warehouse of medical
and drug claims data as well as eligibility information. It also
delivers comparative information including local, regional, and
national benchmarks from an extensive normative research database.
Our Reporting and Analysis
capabilities have blossomed. We can track and forecast healthcare
costs, evaluate benefit plans, forecast the real-life impact of
potential changes to your plans, and evaluate the impact of health
promotion and disease management programs. Utilizing an integrated
data warehouse of medical and drug claims data as well as eligibility
information, TriSurant can manage plan assets in a most effective
manner. In the next phase of implementation, the system will also
deliver comparative information including local, regional, and
national benchmarks from an extensive nationally known normative
research database.
