our pillars

Transparent Health Benefits

  • Utilization Management

  • Alternative Reimbursement

  • Rx Drug Optimization

  • Enhanced Access to Care

HOW IT WORKS

Transparent Health Benefits Pillars

Pillar 01: Utilization Management

It is essential to consistently provide quality care at the best price to keep employees productive and resources free.

Utilization Management brings together the tools to do both!

• Location Matters: Ensure members are getting the BEST care and the BEST price“.

• Higher Quality = Lower Cost

• Healthcare guides to help employees, and their families, get the best care.

• Immediate savings for employers and employees.

• Receive fewer claims and pay less.

• Optimize RX drug costs for employees.

• Implement cost controls to mitigate risk

MEDICAL MANAGEMENT

Implement successful healthcare management to ensure:

The RIGHT healthcare is being accessed:

• At the RIGHT price.

• At the RIGHT time.

CARE NAVIGATION

Ensure members are guided to the highest quality healthcare at the best cost, for ALL services.

ADVOCACY

Reduce confusion and expense with a proactive advocacy program that optimizes outcomes for you and your employees.

Pillar 02: Alternative Reimbursement

Win, win, win!

• Providers get paid faster.

• Employers reduce their 2nd largest expense.

• Employees get more access to higher quality care with lower costs.

TAKE CONTROL!

Who decides the cost of healthcare?

Currently, insurance companies have the most to gain from increasing healthcare costs.

Unfortunately, they also decide how much is being charged and what is being reimbursed.

With Alternative Reimbursement strategies, you take control of your plan, costs, and reimbursements for services provided.

Learn THREE forms of Alternative Reimbursements:

REFERENCE-BASED PRICING

Move away from the opaque bill charge discounts and establish a reimbursement model with a transparent reference point.

DIRECT CONTRACTING

Ensure members are guided to the highest quality healthcare at the best cost, for ALL services.

BUNDLED PAYMENTS

Reduce confusion and expense with a proactive advocacy program that optimizes outcomes for you and your employees.

CASH

If you need medical care, employer plans can be setup to use direct payment methods, think cash or Venmo for healthcare.

Many medical facilities, offices, and doctors are ready to lower their prices for patients who pay in cash because there is no need for extensive paperwork orthird-party adjustment.

Pillar 03: Rx Drug Optimization

Win, win, win!

• Providers get paid faster.

• Employers reduce their 2nd largest expense.

• Employees get more access to higher quality care with lower costs.

TAKE CONTROL!

Who decides the cost of healthcare?

Currently, insurance companies have the most to gain from increasing healthcare costs.

Unfortunately, they also decide how much is being charged and what is being reimbursed.

With Alternative Reimbursement strategies, you take control of your plan, costs, and reimbursements for services provided.

Learn FOUR forms of Alternative Reimbursements:

UNDERSTAND AND STREAMLINE

Rx drug costs typically account for 20%-25% of an employer's healthcare spending.

However, Transparent Health Benefits (THB) can significantly reduce the cost for members and employers with the right strategy. 

GREATER EMPOWERMENT

• Optimize procurement strategy.

• Focus on specialty drug utilization.

• Receive up to 867% off pharmacy costs.

Pillar 04: Enhanced Access To Care

What good is care if employees don’t have the access they need?

Transparent Health Benefits helps companies expand and enhance access to care for their workforce.

One of our most successful methods has been establishing an on-site clinic or partnering with a nearby provider facility.

With on-site clinics, employers see significant cost savings and healthier employees. A company culture that is rooted in strong health practices can also be beneficial to a workforce.

Finding the best providers and maintaining cost transparency is simple and effective!

QUALITY CARE

Did you know you can improve employees’ quality of care while also lowering the overall cost on the budget?

Surprisingly, it’s not as hard as you may expect.

Transparent Health Benefits has multiple methods for employers of all sizes to help save money and establish a healthy culture lowering their healthcare spending and their members'.

CARE ADVOCATES

Navigating care alone can be quite overwhelming for employers, especially for the first time.

With Transparent Health Benefits each plan member has access to dedicated care advocates.

These professionals maintain transparency while recommending top providers to keep employers from overspending on care.

TYPE OF CARE

With traditional insurance plans, employees are very restricted when it comes to providers.

With a self-funded plan, employers and their employees have access to alternative care methods such as telehealth, direct primary care, and on-site clinics.

Enhancing access to care allows employees to better manage their health and get better outcomes while saving in healthcare out-of-pocket expenses.

20%

Transparency leads to significant savings

3500

EMPLOYEES IN OUR LARGEST GROUP

180

MEDIAN GROUP SIZE

0

IDEAL EMPLOYEE OUT-OF-POCKET

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