Reference Based Pricing (RBP)

Product Info

Company Overview

Founded

2011

Employees

103

Funding Summary

None

Clients Your Size

About SentryHealth

SentryHealth is a clinical-first care navigation company that combines data science, technology, and an experienced care team to match members with the best available health care. It blends expert guidance with personalized care plans, empowering members to make more informed decisions while connecting them to high-quality, low-cost care. From virtual health coaching to locating high-quality providers to managing complex medical conditions and prescription drugs, the company drives smarter utilization of benefits, better outcomes, and real cost savings. Show More

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ClaimChoice Administrators

Reviews pending

Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

16 RFI Questions

13 Specific Questions

Product Features

Flexible reimbursement and contracting

RBP members flexibility

Health plans integration

Service cost comparison

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Product Description

Reference Based Pricing (RBP) is a cost-containment strategy with a fixed limit that reduces employer healthcare costs and out-of-pocket expenses for employees. The approach typically has no in-and out-of-network payments, making it ideal... Show More

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Imagine360

Reviews pending

Product Info

Company Overview

Founded

1968

Employees

1,400

Funding Summary

Not Provided

Clients Your Size

About Imagine360

Imagine360 has 50+ years of combined experience. In 2020, Group and Pension Administrators (GPA) joined forces with ELAP Services, EBMS, and Imagine Health, which became sibling corporations through WaterStreet Healthcare Partners. This integration allows our organization to deliver the most experienced and first completely integrated health plan with reference-based pricing as its core.

Imagine360 delivers a fully integrated health plan with the savings of reference-based pricing built in and consistently generates 15–25% savings for 900+ self-funded employers. Imagine360 is entering its next phase of growth with a fresh infusion of capital to expand its comprehensive suite... Show More

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6 Degrees Health

Reviews pending

Product Info

Company Overview

Founded

2012

Employees

141

Funding Summary

Not Provided

Clients Your Size

About 6 Degrees Health

6 Degrees Health is a service-first cost containment company. For many, we set care free from the constraints of traditional networks. For others, we bring integrity to historically opaque billing practices. For all, we leverage unparalleled clinical expertise and innovative data technology to empower employers and their covered employees in realizing the true benefit of healthcare.

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Agility Innovation Partners

Reviews pending

Product Info

Company Overview

Founded

Employees

Funding Summary

Not Provided

Clients Your Size

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AmeriBen

Reviews pending

Product Info

Company Overview

Founded

1958

Employees

615

Funding Summary

Not Provided

Clients Your Size

About AmeriBen

AmeriBen provides comprehensive services in Human Resource and Management Consulting and Third Party Medical Benefit Administration services on behalf of self-funded group health plans.

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ClaimDOC

Reviews pending

Product Info

Min. Group Size

100 eligible

Lives Serviced

300,000

Average Cost

16 RFI Questions

13 Specific Questions

Product Features

Flexible reimbursement and contracting

RBP members flexibility

Health plans integration

Service cost comparison

Show All Features

Product Description

ClaimDOC is an Audit and Member Advocacy firm. There is way too much inappropriate billing in Billed Charges and the Audit is key to removing that fat. Then we cover the member to... Show More

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Marpai Health

Reviews pending

Product Info

Company Overview

Founded

Employees

Funding Summary

Not Provided

Clients Your Size

About Marpai Health

We are the SMART health plan company using Deep Learning, the most advanced artificial intelligence, to empower people to live better, stay strong and spend less on healthcare. Our SMART Health Plan Services System addresses the problems of healthcare past and fuels the new consumer-driven world by empowering patients with new, proactive abilities. We believe Deep Learning provides the best capability to create healthier people and stronger companies by making care more affordable, effective, accessible, convenient and easy to understand. Our SMART system makes it possible for health plan members to do things they could never do before:
•... Show More

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Advanced Medical Pricing Solutions (AMPS)

Reviews pending

Product Info

Company Overview

Founded

2005

Employees

88

Funding Summary

Not Provided

Clients Your Size

About Advanced Medical Pricing Solutions (AMPS)

Turn to Advanced Medical Pricing Solutions (AMPS) for your healthcare cost management services and we will help you achieve meaningful and visible savings for your clients. Here at AMPS we utilize physicians to perform line-by-line audits on all claims we review. This will not only demonstrate an added level of commitment to your clients, it will add a new line of revenue to YOUR company at ZERO expense to you.
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Claros Analytics

4.0 (1)

Product Info

Company Overview

Founded

01/2007

Employees

15

Funding Summary

Not Provided

Clients Your Size

About Claros Analytics

Claros Analytics provides next-generation analytics to model, price and predict health benefits cost. 7 of the top 10 national brokerages are clients and we have over a 90% renewal rate. Stop loss carriers, underwriters, reinsurers, benefits consultants and advisors, plan administrators and plan sponsors, are achieving competitive advantage by pricing risk, modeling health plan changes, defining self-funded opportunities, and budgeting self-funded plan costs using our sophisticated predictive algorithms. Show More

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1.800MD, LLC

Reviews pending

Product Info

Min. Group Size

10 eligible

Lives Serviced

-

Average Cost

16 RFI Questions

13 Specific Questions

Product Features

Service cost comparison

Member advocacy and guidance

Enrolling assistance

Personal support

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Product Description

Designed to ensure fair medical pricing, Medical Bill Negotiation utilizes expert medical advocates to negotiate with hospitals and providers on behalf of 1.800MD members directly. Advocates aim to achieve discounted bills and accommodating... Show More

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bbgbroker

Reviews pending

Product Info

Company Overview

Founded

1995

Employees

Funding Summary

Not Provided

Clients Your Size

About bbgbroker

The Business Benefits Group is a large, independent, full-service benefits and insurance brokerage. Our mission is to serve as a trusted partner to employers in the DC metro area, by providing best in class consulting on complex problems. Our team of professionals bring years of experience from a variety of industry backgrounds, providing a unique perspective and willingness to challenge the status quo.

While we are headquartered in Fairfax, VA, BBG is a regional agency with an international reach, regularly utilizing our solid relationships with every major carrier or vendor in the industry. Show More

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HealthEZ

Reviews pending

Product Info

Company Overview

Founded

1982

Employees

150

Funding Summary

Not Provided

Clients Your Size

About HealthEZ

HealthEZ was founded as Family Health Plan in 1982, establishing the first PPO in the Nation. Our company established medical management services integrated with the network in 1983 and provided an integrated service to many insurance companies, TPAs and large employers, including Northwest Airlines and the Fairview Nurses union plan.

Today we operate as HealthEZ and America’s PPO, under the umbrella of The Araz Group. We have over 150 employees on staff, primarily located in our Bloomington, MN headquarters. Our 40 years of experience operating as an independent network, managed care services company and third-party administrator... Show More

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Professional Benefit Administration

Reviews pending

Product Info

Company Overview

Founded

1985

Employees

Funding Summary

Not Provided

Clients Your Size

About Professional Benefit Administration

PBA is a third-party administrator offering benefits management services to self-funded companies and Taft-Hartley Funds throughout the U.S.

We are committed to continually bringing new ideas and innovative concepts to our clients and providing our self-funded employer groups, Taft Hartley Funds, brokers and plan members the information needed to proactively manage their healthcare costs. Show More

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Crumdale Partners

Reviews pending

Product Info

Company Overview

Founded

2014

Employees

Funding Summary

Not Provided

Clients Your Size

About Crumdale Partners

Crumdale Partners is a diversified insurance firm providing custom, self-funded healthcare solutions to a bespoke set of brokers, consultants, and agents nationwide. We optimize the fragmented health benefits supply chain to reduce health benefit costs and create better outcomes for employers and employees. We sell integrated and unbundled solutions to brokers looking for flexibility in their self-funded and level-funded health plans, pharmacy benefits, stop-loss, actuarial and compliance needs. Show More

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Hines

Reviews pending

Product Info

Company Overview

Founded

Employees

Funding Summary

Not Provided

Clients Your Size

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MedWatch, LLC

Reviews pending

Product Info

Company Overview

Founded

1988

Employees

365

Funding Summary

Not Provided

Clients Your Size

About MedWatch, LLC

Established in 1988, MedWatch is a proven industry leader providing population health management and cost containment services nationwide to a wide variety of clients including TPAs, MGUs, stop loss carriers, employers, schools, hospital systems, Taft Hartley plans and fully insured payers.

MedWatch’s core services include Utilization, Case, and Disease Management which provide early identification, management and mitigation of the health and financial risks for our clients and plan members.

To address the ever-increasing list of costly pharmaceuticals that are available and prescribed today, MedWatch has an on-staff PharmD who is dedicated to... Show More

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EBMS

Reviews pending

Product Info

Company Overview

Founded

1980

Employees

223

Funding Summary

Not Provided

Clients Your Size

About EBMS

EBMS is an industry leader in health risk management and third-party administration of self-funded health plans. For over 38 years, we have outperformed our peers by continuously introducing innovative solutions to improve lives and change the way healthcare is purchased and delivered.

Three core goals drive everything we do:

• Reduce costs for organizational well-being
• Improve the care experience for member well-being
• Make it easy by simplifying the benefit journey for everyone’s well-being

Across the nation, our pioneering strategies are transforming the health and well-being... Show More

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Lucent Health

Reviews pending

Product Info

Company Overview

Founded

2014

Employees

196

Funding Summary

Not Provided

Clients Your Size

About Lucent Health

Lucent Health is a leading third-party administrator serving the self-insured employer market, with a fully integrated care management solution. Lucent Health is human focused and data driven, with plan administration, patient care programs and cost controls all under one roof. Best-in-class care management and concierge care solutions are delivered through Narus Health, a Lucent Health company. Narus Health care management services create a better healthcare experience for employees while empowering employers to mitigate costs. Our technology platform pulls nightly data to more intelligently deliver compassionate care to members and their families, who are supported by a skilled care team.
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90 Degree Benefits

Reviews pending