TeamGail.com
Office Management & Insurance Solutions
PPOGrades: Managed Care Reviews for Health Plans & Underwriters
Unraveling complex PPO provider contracts can be very difficult, often requiring significant experience to interpret them. We understand provider contracts and their cost implications. We have developed a comprehensive program that scrutinizes provider networks. Our PPO program is based upon actuarial standards. It includes an analysis of hospital chargemasters and state regulated transparency data. We inspect provider contracts for inflation clauses. We include a thorough review of hospital billing practices to identify abusive and artificially inflated medical bills. We also analyze the strengths and weaknesses of non participating providers to help underwriters determine the potential for out of network utilization. In addition, we evaluate the PPO's ability to manage the costs of complex specialty care such as cardiology, oncology, neonatalogy, organ failure and high risk maternity.
We collect and analyze all PPO data in a proprietary database. The results are tabulated and carefully monitored. A final detail report is produced for underwriters. Access to the reports, and our tracking system is available only to subscribers via a password protected website application.
Link to PPOGrades, our PPO database - requires a subscription for login:
www.teamdesk.net
To Subscribe now:
Subscribe
We collect and analyze all PPO data in a proprietary database. The results are tabulated and carefully monitored. A final detail report is produced for underwriters. Access to the reports, and our tracking system is available only to subscribers via a password protected website application.
Link to PPOGrades, our PPO database - requires a subscription for login:
www.teamdesk.net
To Subscribe now:
Subscribe
Hospital Charge Analyzer
Our mission is to identify and resolve problematic medical bills, not merely discount charges.
Hospital bills often contain mistakes, are incomplete, or inaccurate. Charges are excessive. Complicated billing structures and abusive billing practices often go undetected. Our team has the expertise and the resources to identify and dispute these charges and we know how to settle them.
We dissect each and every line item of the detailed bills. We use generally accepted and defensible billing, coding, and claim payment standards that model federal CMS guidelines and UCR benchmarks. Our physicians, nurses, and professional billers and coders have successfully negotiated many large hospital bills, including some that already had PPO discounts in place.
Our goal:
Reasonable healthcare payments for reasonable healthcare bills!
Hospital bills often contain mistakes, are incomplete, or inaccurate. Charges are excessive. Complicated billing structures and abusive billing practices often go undetected. Our team has the expertise and the resources to identify and dispute these charges and we know how to settle them.
We dissect each and every line item of the detailed bills. We use generally accepted and defensible billing, coding, and claim payment standards that model federal CMS guidelines and UCR benchmarks. Our physicians, nurses, and professional billers and coders have successfully negotiated many large hospital bills, including some that already had PPO discounts in place.
Our goal:
Reasonable healthcare payments for reasonable healthcare bills!
High Cost RX - stop the price gouging!
We review high-dollar pharmacy charges from inpatient and outpatient
hospital stays, as well as those from physicians, clinics, and
specialty pharmacies. We insure that our clients only pay a fair and reasonable amount and we reduce price gouging for medications.
In addition, we are able to source high-cost injectibles through our strategic relationships with national and local specialty pharmacies that can help deliver these drugs to patients at costs often below AWP.
Our High Cost RX Program is top of the line for savings, delivery and customer satisfaction.
In addition, we are able to source high-cost injectibles through our strategic relationships with national and local specialty pharmacies that can help deliver these drugs to patients at costs often below AWP.
Our High Cost RX Program is top of the line for savings, delivery and customer satisfaction.
