The best clinical and financial outcome for both you and your members.
The HPC Advantage program identifies high risk claims and matches them with a specialty network contract or other savings methodology provided by centers of excellence or other high-quality providers. The result is an improved outcome for the patient, the provider, and the plan without provider pushback.
Key Services and Specialty Contracts:
• In network transplant claim review
• CART Therapy
• Pre-post stem cell transplant chemo
• LVAD implant and maintenance
• Hemophilia-Factor Replacement Therapy
• Cancer / Oncology (including large discounts at Cancer Treatment Centers of America)
• Congenital Heart Defects (preemies and adults)
• Single Case Agreements
• Large in and out of network claims
• Bill review and negotiations
The HPC team of experts will “mine” your precert, case management and other reports to find high risk claims. Then we will scour our extensive list of specialty network contracts to find the best case rate or per diem contract for that claimant. Not all patient’s cases fit within every specialty case rate or per diem contract. HPC will close these “savings gaps” and mitigate plan costs by recommending other savings methodologies such as bill review and negotiations.
Allowing HPC to shop our extensive network of specialty network contracts will ensure that you have the best solution in place with minimal effort because we do all the “heavy lifting” for you.