CenBen USA , an Expert in Benefits Administration |
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As a client of CenBen USA , you not only benefit from the strength of a national organization but also a local service presence. Some of our advantages include:
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More than $11 million invested in technology in the past three years. |
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Leveraging our more than 500,000 covered individuals to obtain highly competitive contracts from vendors used by our clients |
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More than $40 million in stop loss premiums with high quality markets, ensuring continuity and fairness in coverage and underwriting . |
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Growth Based on Long-Term Client Relationships
CenBen USA is one of the fastest-growing TPAs in the industry, but are most proud of our 96% client retention rate since 2000. We have achieved this through an unyielding commitment to open communication and independence. We have no preconceived products or solutions. We listen so that we can help you identify your needs and deliver solutions that meet those needs most effectively. It begins during the proposal process with a thorough review of your current plan, stop loss arrangements, and understanding your objectives. Then, it continues with high-quality management information and regularly scheduled account management communication when you are a client.
An Important Service...Managing Your Money As If It Were Our Own
Since our inception, we have taken our role as the manager of your benefits expenditure very seriously. This means we bring to you a comprehensive portfolio of services and a team that will manage your plan to your financial goals. As a result, our trend rate has been roughly 50% of national averages in the last three years. Here is where we excel: |
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Our regional presence, allows our account management and operations teams to gain a wealth of knowledge in local healthcare markets. |
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CenBen USA has dedicated a team of resources to assist our clients in choosing the PPO Network(s) that provide the most effective balance of access and discounts. As your representative we cut through the facade of promised "discounts" to analyze contracts, re-price claims and check potential disruption to your employees. If appropriate, we are able to develop customized networks and have direct contracts in place with more than 400 hospitals and more than 25,000 physicians. |
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We maintain a partnership with a URAC-accredited (Utilization Review Accreditation Commission) medical management vendor that assists us in reviewing treatment plans and assessing the appropriateness of services and charges before and after a claim is submitted. |
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Our High Impact program uses sophisticated predictive modeling and risk assessment programs to identify covered participants with the greatest potential for incurring significant claims. We then help customize their treatment and self-management plans to minimize future high-dollar claims. |
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During the last three years, CenBen USA has invested over $11 Million in industry-leading technology including:
A sophisticated IVR system for provider service
Web access for clients, covered participants and providers
DataSCOPE - a sophisticated management reporting system
Our highly automated and consistent benefits administration system
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Our ClaimsWatch program has been designed to ensure that we are fair in our processing, but have the controls in place to eliminate inappropriate expense. This includes: Our ClaimsWatch program has been designed to ensure that we are fair in our processing, but have the controls in place to eliminate inappropriate expense. This includes:
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Fully-integrated clinical edits, billing and "flags" applied to providers, patients, treatments, diagnoses and any other area of concern |
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On-site clinical resources |
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Application of sophisticated post-processing surveillance software and fraud detection software, plus use of a Special Investigations Unit (SIU) to monitor activity. |
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Aggressive pursuit of savings on all claims submitted from non-contracted providers. We have gained an average discount of 23% on more than 50% of the claims we pursued for a discount. |
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Unique electronic connections with vendors and procedures that enhance controls around Medicare, integration, coordination of benefits and third-party liability. | |
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We maintain a partnership with a URAC-accredited (Utilization Review Accreditation Commission) medical management vendor that assists us in reviewing treatment plans and assessing the appropriateness of services and charges before and after a claim is submitted. |
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All in all, these programs save our clients $0.48 - $0.55 of every $1.00 billed by health care providers. |
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