members

The Alliance Partners with Quantum Health to Offer
Coordinated Health/Care™ Service

Through a new partnership with Quantum Health, The Alliance is proud to offer members the Coordinated Health/Care™ integrated health management service. By combining the various aspects of care management and customer service into one robust system, Coordinated Health/Care™ delivers better experiences for individuals and a proven track record of cost savings for employers.

With Coordinated Health/Care™, dedicated Care Coordinators work directly with employees, their families and their physicians to offer information, guidance and assistance as they navigate the often complex health care process. The Care Coordinators provide a single point of contact for benefits, eligibility and claims service, and all medical management activities are integrated into a single, real-time database.

In doing so, Coordinated Health/Care™ reduces the fragmentation common in the health care system, which can lead to unnecessary events — duplicated tests and procedures, incorrect or incomplete information, needless delays — that waste patients’ time and have been shown to have a 33 percent increase on the plan’s bottom line.

The real strength of Coordinated Health/Care™ is its ability to reduce or eliminate health care events that never need to happen — and the costs incurred from these errors. Most employers using Coordinated Health/Care™ have seen a reduction in actual claim costs in the first year. After three years with the program, claim spending has averaged 21 percent below the industry trend. Moreover, 92 percent of patients have been satisfied with the assistance offered by Coordinated Health/Care™ over its nine-year track record.

Coordinated Health/Care™ is available to Alliance member companies with 200 or more employees across all networks. For more information, contact Bobbi Jones, product management specialist, at 800.223.4139, x 6638, or bjones@the-alliance.org.

You can also visit the Quantum Health Web site to learn more.

Operational Excellence and Efficiency

After your employees and their dependents visit the doctor, The Alliance receives their claim and applies your Alliance rate before passing this claim on to your claims administrator.

Each year, more than 780,000 of these claims come to The Alliance. More than 76% are sent electronically. Our goal is to complete this process within 3 days, but we far exceed that:

• Electronic claims: 0.01 day
• Non-electric claims: 1.76 days
• All claims: 0.43 days

Our accuracy rate is 98.38%. Last year we also answered more than 12,000 calls from providers, claims administrators, employers and enrollees.
Want to learn more about the claims process?