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Third
Party Administration Services
Med
Admin Solutions, Inc,. High Quality Managed
Care Administrative and Employee Benefit Administration
Services
- Claims Adjudication and Encounter Processing
- Capitation Processing and Management
- Claims Re-Pricing
- Member and Benefit Administration
- Medical and Case Management
- Utilization Review and Outcomes Assessments
- Call Center and Customer Service Operations
- Data Analysis and Reporting
- Electronic Data Interchange
- COBRA, Flexible Benefits and HIPAA Administration
- Premium Billing
- Placement of Re-Insurance
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Third Party Administration
Services are available through MedAdmin Solutions,
Inc., an eHDL company.
MedAdmin Solutions, Inc offers comprehensive, high
quality Administrative Services for Managed Care Organizations
and Self Funded/Employee Benefit Organizations.
Experience The Difference!
- Low entry cost for service – Pay
as you go
- Produce revenue opportunities for current
clients
- Business and Electronic Links between
Payers and Providers
- Real-time information that reduces risk
- Health Maintenance Organizations (HMO’s)
- Independent Practice Associations (IPA’s)
- Insurers
- Management Services Organizations (MSO’s)
- Physician-Hospital Organization (PHO’s)
- Self-Funded Employers
Claims Adjudication
& Encounter Processing
- Claims Adjudication and Encounter Administration
for contracts in Self-Funded Employee Benefits and
Managed Care settings
- Identify and manage billing errors, unnecessary
services, and disallowed charges
- Receive and process Claims in many formats
Capitation Payment Processing
& Management
- Builds Contract Management for complex Capitation
Payment models
- Manages reimbursement arrangements and fee schedules
for various Providers and Payers – Fee For
Service, Withholds, Per Diems, and Case Rates
Member Eligibility & Benefit
Administration
- Maintains Membership and Benefit Information by
Plan
- Electronic, HIPAA-Compliant EDI transactions available
to Providers
Placement of Reinsurance Coverage
- Competitive Rates for Reinsurance due to strong
buying power
- Manage Reinsurance Payouts
Medical and Case Management
System
- Established Clinical Criteria administered by
Nurses and Physicians
Data Analysis and Reporting
- Capitation and Utilization Analysis
- Member Satisfaction Reports
- Provider Profiling
- Network Composition Analysis – Geo-Coding
- Outcome Reports for Benefit and Plan Analysis
- Longitudinal Studies associated with Enrollment,
Utilization, Clinical, IBNR, and financial Management
Call Center and Customer Service
Operations
- Trained Customer Service staff and management
- State-of-the Art Customer Relations Technology
- Provider Reimbursement Management
- Billing and Premium Collections
- COBRA and HIPAA Administration
- Flex-Benefit Administration
- Utilization Management, through Referral and Authorization
Tracking
MedAdmin Solutions, Inc.
Providing Information Systems and Administrative Services
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