Services
effectiveness and efficiency. Our comprehensive
administration services, such as proven and efficient
processes for claims review and processing, will benefit
you every step of the way.
Serving Your Health Plan
Look to APA to bridge the team players of your self-funded health plan solution. Whether it’s a request for plan performance analytics, a member seeking guidance on a healthcare bill, or a provider requiring eligibility data, APA has it covered.
Custom-built Plans
APA designs a healthcare plan tailored to the uniqueness of your organization, evaluating and understanding your organization’s structure to identify the best plan for your needs.
1. Evaluation
First, we analyze your healthcare expenses to determine if self-
funding is a good fit for your
business.
We review your current healthcare spending and utilization trends to make an accurate assessment and recommendation.
2. Development
Building on this analysis, we create a custom and cost-effective
healthcare plan that meets your needs and the needs of your employees.
We guide you in decisions
including networks, providers, plan structure and coverage levels. Then, we mitigate your financial risk by setting up protective funding mechanisms like stop-loss insurance.
3. Transition
Last, we help you transition from
your current insurance plan to your new self-funded plan.
We oversee employee education and communication, monitor and manage administrative aspects,
and facilitate partner support to
help ensure a successful transition.
Cost Regulations
Our in-house cost-containment team analyzes and evaluates vital coverage data to continuously obtain the lowest rates for our clients and maximize the effectiveness of your self-funded plan.
Pre-Authorizations
APA helps employees get the care they need by providing reviews and referrals informed by clinical professionals, utilization data and quality guidelines
Fraud Protection
Ongoing bill audits and human oversight minimize waste, prevent policy abuse and reduce errors and cost discrepancies.
Group Discounts + Negotiations
APA extends payment plan flexibility on a choice of in-network and out-of-network claims, driving costs lower.
Compliance Management
The constantly changing complexities of federal requirements can be a burden with consequences.
APA manages regulatory and compliance changes and additions, so you don’t have to.
regulations that are important considerations in the world of healthcare.
- Affordable Care Act (ACA)
- Health Insurance Portability and Accountability Act (HIPAA)
- Consolidated Omnibus Budget Reconciliation Act (COBRA)
You need:
A Healthcare Support Team Who Cares
With APA, You Get:
Seamless Integration
Avoid disruptions to member coverage with a smooth transition to your self-funded cost-saving health plan.
Plan Performance Tracking & Insights
Get instant access to your plan history, analytics and predictive forecasting through your personal plan portal.
Comprehensive Clinical Support
Gain access to quality care from physicians, hospitals and other medical professionals while reducing healthcare costs and OOP expenses.
Your helping hand in healthcare.
