Third Party Administrators

Administrative fees have fallen, and competitive pressures are keeping them down. Yet your clients are expecting even more services and greater cost-cutting assistance.

Health Decisions, Inc. offers products that can expand your services, grow your market, and increase your income without requiring any new technology or change in your claims-processing systems. We review claims after they are paid and report enrollment data to your specifications.

Third Party Administrators that use Health Decisions can build their business by:

  • Enhancing the value of their claims payment service
  • Increasing service and reporting capabilities
  • Producing additional income opportunities

Because Health Decisions is at the cutting edge of technology we can help TPAs better deal with:

  • The fallout of automated adjudication of claims
  • fraud and abuse detection and prevention
  • Medicare recovery
  • identifying the best Continuous Quality Improvement (CQI) solution
  • satisfying HIPAA and other regulatory requirements

Health Decisions Post Payment Administration system for payors includes emphasis on span of control, financial return, staffing, implementation, and CQI. Our suite of services covers data handling, data processing, case investigation, and case updates.

Health Decisions accepts claims data in almost any format and provides it to TPAs in Microsoft and web-compatible formats.

Do you have Questions? We have answers! Click Here to contact us!

“Health Decisions has been very good to work with. The programs and reports have been developed with our needs in mind, not changing our existing procedures. Health Decisions works hard to customize programs that fit our needs, not changing our processing guidelines.”


Marla Ross
Claims Manager
Mid American Health

Check out the latest episode in our "Prudence Says" video series:

Prudence Says: Get READY to control your plan data!

 
409 Plymouth Road, Suite 220 • Plymouth, Michigan 48170
phone 734­.451.2230 • fax 734­.451.2835
© 2011 - 2017 Health Decisions, Inc.