CLAIMSBRIDGE NAVIGATOR - NETWORK BUILDClaimsBridge builds custom, high-performance provider networks that offer Medicare-based direct provider agreements for Self-Insured Employers, Third Party Administrators, Accountable Care Organizations (ACOs), Health Insurance Brokers, Benefits Administrators, and any organization looking to gain control over healthcare quality, coverage, and costs.
- Providers selected based on client’s specific needs
- Better discounts are contracted from fewer providers
- Direct provider contracts are based on Medicare methodology
- High-Performance Networks remove low-value cost layers
A PROVEN METHODOLOGY
We help self-funded employers build and operate their own cost-effective, custom health provider networks. Our 3-step methodology ensures that each custom network meets the client’s unique needs.
Discovery and Needs Analysis – We interview employers to understand their goals and priorities and what they want to achieve with the network. Employers often share a list of providers they want in-network.
Network Design and Build – Armed with the output from Discovery sessions, the ClaimsBridge team initiates outreach to physicians, hospitals, and ancillary care providers and handles all aspects of provider acquisition and alignment.
This necessary groundwork includes provider recruiting, negotiations, and contracts. Direct provider networks are based on current Medicare methodologies. As agreements are put in place, we conduct provider and employee education and launch the network.
Ongoing Execution and Support – Once a custom network is launched, the ClaimsBridge team manages the network, assembles a Provider Directory, and handles provider communications and support. As network needs change, the ClaimsBridge team manages network expansion activities. When required, the team also provides additional claims processing support.
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