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Cost Management

Employee benefits are expensive. Meritain Health’s strategic cost management solution has saved our clients millions on claim costs. And it’s included as part of every Meritain Health employee benefits plan.

 

We provide a strategic solution for most claim situations: in-network; out-of-network; high-dollar; complex; pharmacy; fraud, waste and abuse; and dialysis claims. This is accomplished through our proactive claims review, code edit, audit and negotiation processes. 

 

Our relationships with more than 60 national, regional and local networks offer our clients savings on both in- and out-of-network claims. This is made possible through multi-tier network hierarchies, negotiation and savings on a greater percentage of employee claims, and coordination with stop loss.

 

Our best in class solution provides:

 

  • Strategic high-dollar claims review and negotiation.
  • Aggressive in- and out-of-network negotiations.
  • Premier, hassle-free dialysis management. 
  • State-of-the-art reporting capabilities.
  • Facility charge review of out-of-network inpatient and outpatient facility claims.
  • Transplant networks including Aetna Institutes of Excellence and Institutes of Excellence  Transplant Access Network by Aetna.