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TPA Services
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Service Overview
Providing our clients excellent service is what Medical Claims Management Corporation is all about. We seek to partner with you in
order that you may realize the benefits of self funding. Our goal is to deliver everything our clients need to provide effective benefit plans and service to their employees. |
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Advantages to Self Funding:
- You may design a Plan that, within reason, is tailored to your employees and their needs.
- Your dollars are earning interest at all times. Instead of an insurance company making money on your dollars, you reap the benefit.
- Your Plan's fixed cost should be reduced. This simply means that of each dollar you and your employees pay in, more is left from which claims can be paid and reserves established and maintained.
- You have the opportunity to reap the rewards of a low claims year. This usually results in a substantial fund balance, or reserve, which can then possibly be used to offset needed adjustments or to add other
benefits.
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Summary of Services:
- Assist in procuring Excess Risk Coverage.
- Design and prepare the Employee Booklet (Summary Plan Description).
- Prepare the Master Contract (Plan Document).
- Design and Prepare Employee Identification Cards.
- Design and prepare Claim Forms and Applications.
- Design and prepare Bank Forms (Checks).
- Provide a Monthly Billing Audit (Either list billing or simplified).
- Provide Monthly Claims Reports.
- Provide Annual Reviews and Future Cost Projections.
- Provide Utilization Reports.
- Assist in preparing applicable Government Forms.
- Assist in complying with new and existing Federal requirements (e.g. COBRA, ADA, FMLA, HIPAA, etc.)
- Claims Adjudication and Payment
- Administer the eligibility and enrollment of employees.
- Provide HIPAA Certificates of Coverage.
- Communication with your employees and their providers of service.
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