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Past claims review and predictive modeling (Get your TPA/ASO reports and we'll look at them together)
Feasibility Analysis (Determine if medical travel will solve your problem before you start)
Attempt last-ditch efforts to negotiate better direct-with-local-provider solutions
Explore high-cost pharma grants, and compassionate discount programs not available from your PBM
Medical Travel Pilot Program design and ERISA/HIPAA compliant documentation
Narrow Network Development (Pick just 3 high-value providers and start saving money)
Program Launch / a user-friendly, medical travel benefits portal just for your company
Specialized Travel Planning & Case Management at a competitive hourly price
Front-end Claims Audit; OK to Pay - don't pay more than you should
Get detailed quality, savings and utilization reports to prove value and effectiveness and inform expansion decisions
Program expansion when you need it, for the right procedures
Lasered claims cost containment. We help manage the surprises.

Start with a retrospective utilization review to help you identify the areas of concern in your claims spend and take action
If you use a any predictive modeling service or software, we incorporate output reports in the feasibility and project savings potential in each surgical or diagnostic category
We will devise a plan for lasered claims to reign in costs for continued catastrophic cases not covered by your reinsurer
If you like, we'll accompany you to approach your local providers with one last chance to sharpen their pencil before driving by them or flying over the top of them
If your local providers won't cooperate, we'll design your medical travel pilot program and help you evaluate and contract with candidate providers in the specialties you need
You can start your program with only 4-6 cases in the first year
We'll help you establish proof of concept first, adjust your program as needed, and then expand in the select specialties you need.
How much you ultimately save PEPM and in the aggregate is relative to the number of plan participants who elect to use the programs you offer and the services they utilize

Our ideal client

Our ideal client is a small- to medium-sized employer (up to 2500 lives)
We specialize in working with employers that are considered too small to be of interest to other firms

We work quickly so you start saving as soon as possible

Have your new benefit program in place and start saving money in as little as 4 months
We have experts on call to help you with ERISA plan documents creation
We work with your existing TPA or ASO; no need to bust up relationships with brokers or other advisers. We're no threat to them.

It isn't simple math: Not every case you paid for in the past would have elected to travel to access care at a lower price.
Reality check: At first, only a small percentage of employees, dependents and retirees will elect to travel unless you create incentives to try it.
Ease of Use: The program pathway must be easy to enter. We'll set up a self-service, online portal your plan participants can use to find out if they qualify and get started on pre-authorization in one click.
Who and Where: The destinations and available providers must be attractive to your plan participants.
Rural vs Urban: Rural-dwelling plan participants will be more likely to try your program because chances are high they already drive longer distances to seek surgical and specialty care.
High-cost Drugs: Sometimes, the problem isn't surgeries. Save plan dollars and help your plan participants afford their high-cost medications with solutions your PBM doesn't offer.

Mercury Health Travel