What can Integrity Administrators offer you?
Let us design a health care plan tailored to meet your needs. We will secure the networks and ancillary providers to make the plan easy for employees to use and cost effective to the employer.
Plan Document Review & Drafting
Integrity Administrators, Inc. will draft your Plan Documents, or review your existing document for government compliance. We also prepare Form 5500 and Form 1095C on behalf of employers, as required.
Summary of Benefits & Coverage
Under the ACA law, group health plans are required to provide consumers with a concise document detailing, in plain language, information about health plan benefits and coverage. This summary of benefits and coverage document helps employees to better understand their coverage and allows them to easily compare different coverage options. We can prepare these forms for you.
Consolidated Billing Administration
We can process the monthly premium billing and remittance to the proper carriers, PPOs, and any miscellaneous service vendors. All the billing information is then consolidated into customized monthly reports for the employer.
Full Claims Payment Adjudication
Your Plan Document determines the amount allowed, the patients' responsibility and discount amount. Integrity Administrators, Inc. will use this information and initiate the claim payments. An Explanation of Benefits (EOB) and remittance advice are created and sent out to the employee and provider immediately following full adjudication of the claim.
PPO Network Access & Non-PPO Claims Negotiations
In addition to direct PPO contracts, we are also partnered with national claims discount negotiators for Non-PPO providers.
Precertification & Eligibility Status
To help ensure proper care is provided to our members, provider offices can obtain precertification and eligibility status when required, so that the member receives their intended care on schedule.
Utilization Review & Large Case Management
Our affiliated Utilization Review and Large Case Management companies provide skilled case managers to work closely with patients who have severe or chronic illnesses. The case managers advocate on the patients' behalf with the various healthcare providers. They ensure that the services provided are meeting the patient’s needs both in and out of the hospital to achieve the best outcomes.
Integrity Administrators, Inc. works with Disease Management providers to improve a patient's quality of life. The goal is to improve the long-term health of the members.
Prescription Benefit Management (PBM)
We partner with the best national Pharmaceutical Benefit Managers to offer customized prescription benefit plans using local pharmacies and mail order services. We design our pharmacy benefit plans to meet the individual needs of our clients using insightful cost-saving solutions for self-funded plans, as well as other types of plans.
Health & Wellness Programs
Integrity Administrators, Inc. stands by the numerous studies on effective Health and Wellness Programs. In these studies, it has confirmed that medical costs are lower when providing wellness advocacy programs in the workplace. Wellness Programs are encouraging physical fitness through gym memberships, regular exercise, nutritional coaching, weight loss programs, smoking cessation courses, on-site health screenings and flu shots.
We can eliminate the employer's burden by completing the required compliance services. This includes COBRA notices, enrollment, premium collection, monitoring & reporting.
Plan Management Reporting
Using our management system, we monitor and provide reports so you know how your plan's benefit dollars are being used. Our performance reports include:
- Monthly Aggregate & Specific Excess Loss Reports
- Benefit Analysis Reports
- Claims Lag Study
- Eligibility Reports
- Provider Payment Analysis
- Hospital Utilization Statistics
- Diagnosis Analysis
- Weekly and Monthly Claims Check Registers
- Provider Comparison Analysis
- Loss Ratio Reports
- Length of Stay/Place of Stay Reports
- Ineligible Claims
- Co-Payment and Deductible Analysis
- Custom Renewal Reports
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