Claims Monitoring:

Actively Identifying Savings

2 CLAIMS

Identified and re-priced by Crumdale for higher discounts

$45K+ REQUESTED

The amount originally requested from the group by the TPA

$42K+ SAVED

Savings when in-network claims were correctly processed with only $3K due from the group, NOT $45K+

The Situation

One of our broker partners has a client that is a full-service medical center in Texas. The client was experiencing extreme increases in their medical claims spend without significant plan changes to merit the high costs.

The incumbent carrier program restricted the company’s ability to access medical claims information and failed to offer cost saving solutions.

Due to the lack of transparency and poor medical claims management with their incumbent program, the company worked with their broker to switch to Crumdale Specialty to transparently reduce costs through a proven claims monitoring process.

Goals

CLIENT:

Work with Crumdale to develop and implement an integrated claims management approach that identifies savings with vendor oversight.

BROKER:

Obtain transparency and cost containment for the client through Crumdale’s specialty claims management process and services.

The Results

With Crumdale’s active medical claims monitoring process and proven cost containment solutions, we identified two claims for additional discounts and delivered the group $42,500 in savings.

Pricing

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