Laserfiche WebLink
Proving What’s Possible in Healthcare <br />This document contains important terms and conditions which are incorporated by reference into and becomes <br />part of the terms of your contract with us. ©2024, Healthcare Management Administrators, Inc. <br />Product Description Price <br />Care Management <br />HMA’s Care Management suite of services is an in-house <br />program that encompasses pre-authorization, utilization <br />management, case management, behavioral health and <br />steerage. HMA’s care management team serves members based <br />upon their diagnosis offering full support of the member’s <br />healthcare journey, as well as oversight of plan spend. <br />1. Utilization Review (Prior Authorization) including Population <br />Health, Specialty Health, Intake <br />2. Case Management including Member Support (Clinical), <br />Transition of Care, Continuity of Care, and Discharge Planning <br />staffed by our in-house, highly-skilled, certified Case Managers <br />and Register Nurse (RN) Case Managers. <br />•Educate members about their health and healthcare options <br />•Ensure members receive care at the appropriate level and <br />location <br />•Identify and coordinate resources to support member health <br />needs <br />•Coordinates medication administration with providers when a <br />client chooses our preferred PBM partner contracts <br />•No “criteria” for Case Management support <br />$3.75 PEPM <br />Required with our <br />base administration <br />services <br />COBRA <br />Administration <br />Services <br />COBRA, Continuation of Coverage, is an important part of health <br />plan administration. It can be time consuming, and complex given <br />today’s ever-changing HIPAA compliance regulations; however, <br />with the help of our comprehensive COBRA service and <br />dedicated team, clients can save time and energy. <br />we will notify participants of COBRA continuation coverage rights <br />upon the occurrence of a qualifying event and collect premiums <br />for continuation of coverage with distribution to vendors. All <br />COBRA eligible benefits (Medical, Dental, Vision, FSA, EAP) are <br />included in the administration. <br />Online payment services for participants. <br />See the Actuarial and Compliance product pages for rates on <br />premium equivalent & COBRA rate calculations. <br />$1.35 PEPM <br />Care Management and COBRA <br />* <br />5