 |
|
|||
UMR has a dedicated support team to help with network issues and
concerns. They work directly with local
UnitedHealth Networks (UHN) contractors on access issues and network
development. We have direct access into
UnitedHealthcare’s re-pricing system to assist with discount disputes
and appeals. We can also help members find
network providers and assist with specific network
arrangements. We will work with our local UHN contractor to
facilitate direct customer/network arrangements.
When we determine that UnitedHealthcare’s Options network is a good choice for a client it’s because we can see substantial savings. In this real life example below, one of our clients was experiencing a 31.4 percent savings on claims with their old network. Just by switching to Options, where their members have access to fully credentialed physician specialists and other health care providers, this client saved 49.3 percent. 
Of course it’s not just about discounts. The Options PPO network
provides our customers with the flexibility they
expect from a TPA. Options PPO network accommodates most benefit
plans. Steerage requirements are less
restrictive and we have the ability to quilt in other networks when
necessary.
Because we have relationships with more than 100 other PPO and PHO local and regional networks along with access to multiple national networks, we can provide access and savings to clients whose plan members may be located in areas not well served by UnitedHealthcare networks. We can mix and match these networks as needed. This is what sets us apart from carriers and other TPAs. The UMR network contract administration and analysis team works directly with UHN and our other network partners to balance customer needs with network rules. Strict confidentiality and security firewalls allows us this network flexibility. 880,000 of UMR’s 2.2 million members access non-UnitedHealthcare networks. As we mentioned, we offer quilting of networks to provide employees access to providers when a single network won’t do that.
UMR’s goal is to understand your network strategy and provide recommendations to improve your competitiveness as well as seek out new networks and network products. We will help you select the best network, and negotiate contracts and network access fees on your behalf. |
Other Core Products
|
|||
