What is driving your decisions today?

Are you looking for a true partner that understands and guides you to the right reimbursement strategy for your client or group?

As healthcare reimbursement evolves, it eludes even the most seasoned reimbursement and health plan professionals. Wouldn’t it be easier if you could rely on a resource who stayed in front of market trends, as well as CMS and other regulatory changes?

Are you struggling to keep client and member satisfaction rates up with declining plan savings and unpredictable plan costs?

It’s time for empowerment! Gain credibility, improve operations and experience more positive reviews through intuitive business decisions based on analytics and specific modeling scenarios.

On a scale of 1 - 10, how would you score your claims flow management?

If your answer is less than 9, this warrants a closer look at the services you’re receiving. 10 IS achievable with automation, rapid implementation, portal access and flexible contract management.

How many different clinical resources and software systems do you currently utilize to manage patient care?

What are the benefits of having everything visible in ONE place - Utilization, Case and Disease Management PLUS Care Concierge and Balance Billing activity? Priceless!

Our Solutions

VISIUM™

Pricing for Medicare, Medicaid, and Commercial + Advanced Editing

Get to the true cost with our proprietary pricing and editing tool, including gap-fill offerings.

BENCHMARK

Plan Modeling + Analytics

Analyze reimbursement under alternative contract scenarios and determine the best strategy for your group/client and much more.

NAVIGATOR

Patient Advocacy + Balance
Bill Support

Patient Advocates educate, validate and communicate all in the name of the plan member. More than a concierge - a true advocate!

CARE ADVISER

URAC Accredited Health Utilization + Case Management

Backed by nurses, we embrace care and technology to deliver the full spectrum of care management.

PROTECTOR

Balance Bill Avoidance / Escalation Support + PACE

PROTECTOR is fueled by The Phia Group, an industry leader in the self-insured market. Foolproof your plan and say goodbye to reimbursement headaches.

MENTOR

Reimbursement
Education + Consulting

New to the world of reimbursement or in need of expert steering for a new or special client? Maximize your business with our expertise.

INNOVATE360

Complete Reference-Based
Pricing Solution

Take a closer look at how this turnkey program increases savings and satisfaction.

ENCOMPASS

Prospective Bundled
Payment Solution

Plan members, payers and providers benefit across the board, with price transparency, higher quality care and more.