MedBen provides comprehensive third party administrative (TPA) services to help larger businesses deliver a self-funded medical benefits package. Self-funding offers the advantage of flexible plan design and greater cash control, plus reduced administrative costs. We deliver this advantage with all of the expertise and technology you would expect from a full service insurance carrier, so that you can be comfortable that your medical claims will be managed in a cost-effective manner.

Claim processing is, naturally, an important part of what a TPA does. But MedBen does more than just “process” a claim. We strive to provide businesses with peace of mind in a variety of ways – and our services begin long before the first claim is incurred.

Superior Service
MedBen assigns every TPA client a Group Service Representative (GSR) team, who guide the employer through plan implementation and employee enrollment. Following implementation, the representatives continue to serve the employer, personally handling day-to-day needs and answering questions. The GSR team works to exceed the expectations of the employer with every encounter.

Employee needs are addressed by MedBen’s Customer Service Department. Extended service hours give participants the flexibility to call at their convenience. What’s more, representatives have access to real-time claims information, meaning 95% of employee inquiries can be resolved with one phone call and within minutes.

Solid Performance
100% of medical claims are electronically processed at MedBen. Our electronic data center bar codes and scans paper claims, converting them to digital documents. By doing so, we can track claims at every point in the process.

Our automated system also contains more than 300 auto checks to ensure claim accuracy. Rebundling software captures inappropriately coded and billed claims, saving an average of 2-3% in claims dollars annually. 100% of this savings is passed on to the customer.

MedBen matches smart technology with smarter people. Our claims examiners are committed to meet – and exceed – rigorous accuracy and turnaround standards. This fact is proven daily through an audit of 5% of each examiner’s claims. Moreover, annual audits of random claims conducted by an independent accounting firm consistently receive a 100% accuracy rating.

Integrated Medical Management
MedBen provides on-site utilization review and case management through a relationship with American Health Holding, Inc. (AHH). Precertification of hospital stays and outpatient surgery allows for early identification of major health concerns, monitoring of acute care, and planning of appropriate post discharge care, in an attempt to return a patient to an optimum quality of life.

Money-saving Measures
MedBen takes an active role in helping employers manage plan costs. Every client is entitled to a complimentary mid-year plan review that includes a claim cost and utilization analysis, plan design review and multi-year plan strategy.

Additionally, we maintain a strong portfolio of regional and national provider networks to create the best network solutions for our clients. Our long-standing relationships result in maximum network savings.

Lastly, we custom fit medical benefit services to best meet employer needs. We welcome the opportunity to discuss new innovations that are right for your business... and know you'll experience the MedBen peace of mind our existing customers already enjoy.

For more information about MedBen medical TPA services, please e-mail our marketing department at marketing@medben.com.