Health Plan Management
Network Advantages — a seamless PPO program that connects local BlueCross® and BlueShield® PPO networks nationwide
- Independence Administrators PPO Network
- The Philadelphia region’s largest PPO network with over 25,000 physicians and 100 hospitals
- BlueCard®program of health care providers
- 88% of physicians and 99% of hospitals across the U.S.
- Blue Distinctionsm Centers — for bariatric surgery, cardiac care, and transplant services — that meet rigorous quality standards, and consistently demonstrate positive results
When you select Independence Administrators, you optimize your health benefits investment with our integrated services.
Independence Administrators provides a comprehensive program of high performance services, tools, and resources designed to help you maximize your benefits investment and support the health and satisfaction of your workforce asset. A dedicated team of cross-functional, client services representatives ensure that your plan receives the attention and management services it needs.
Integrated Services for Health Benefits Management
- Nationally recognized BlueCard®program of health care providers delivers your members access members wherever they live or travel in the U.S.
- Health management programs provide compassionate care management to ensure services that are medically necessary, support members’ health care decisions and treatment compliance, promote healthy lifestyles, and identify and manage chronic conditions.
- Stop-loss services for placement protect your risk — through established relationships with A-rated carriers — and administration of aggregate and specific coverages.
- Actuarial and underwriting services provide comprehensive reporting of plan performance, evaluation of plan design options and cost implications, monitor deposit and reserve requirements, monitor network utilization, and identify risks through predictive modeling.
- Member support services offer centralized, dedicated customer service call center teams and pre- and post-enrollment communications services, and online tools and resources.
- Funding administration and reporting provide weekly and monthly recaps of benefits disbursements, deposit maintenance, and coordination of transactions with third party vendors, stop-loss MGUs, and carriers.
- Technology-driven eligibility and claims management ensure efficient operations and support electronic data interchange (EDI), automated adjudication, paperless claims processing, stop-loss, coordination of benefits, subrogation, and appeals.
- Performance monitoring and reporting ensures compliance with your service-level expectations and our high standards.
Our underlying proprietary technology enables a high degree of control over flexibility, scalability, and responsiveness to meet each client’s unique needs and to leverage capabilities across our customer base. Third party solutions are thoroughly evaluated and selected to ensure operational efficiencies, controls, and integration with our technology infrastructure.
Through Independence Administrators, clients receive a continuous 360° approach to help you plan, manage, and assess your health benefits program.