For Health Plans

As a trusted Medical Ally to Care Management teams, we can help members facing specified diagnoses find top specialists for a second opinion and learn about the best treatment options, including potential risks and benefits—enhancing the results of your Care Management programs and adding value for your national accounts.

We bring deep clinical expertise and the latest evidence-based information to ensure a highly personalized and satisfying member experience. Our objective, independent support improves clinical outcomes and quality of care, increasing member satisfaction, and reducing medical expenditures.

We use an integrated, yet modular Expert Opinion and Treatment Decision Support model meant to optimize several key aspects of a medical plan: the correct diagnosis; the most appropriate, evidence-based treatment plan; the highest quality and appropriate specialist within your network; the right hospital or COE; and finally, coping mechanisms for the family and patient.

Program Components

Expert Medical Opinions
that make the most of
your networks
  • Industry-leading physician quality algorithm spanning claims data from over 250 million patients on outcomes and experience for 95% of U.S. physicians
  • Telephonic verification of new patient/appointment availability
  • COE integration
  • Both in-person and remote options
Treatment Decision
Support for your
high cost conditions
  • Hip and knee replacement
  • Lower back surgery
  • Hysterectomy
  • Weight loss surgery
  • Cancer
  • Mental Health
Industry-leading
engagement
strategies
  • Participant communications programs
  • Incentives and requirement programs
  • Identification and stratification with targeted outreach
Plus full integration with your Care Management teams that ensures collaborative care,
cross-referrals and a seamless member experience

What Sets Us Apart

Objective, personalized, comprehensive support 
along the entire healthcare journey

Deep clinical expertise leveraging the latest
evidence-based treatment information

Support for all medical conditions, focusing on high-cost diagnoses

Industry-leading engagement, outcomes and satisfaction rates

Data-driven quality physician algorithm and matching process

Identification and stratification with outreach

Rapid implementation and integration with your service model
 

Contact Us to Learn More

We consistently deliver cost savings for our customers, with a book of business ROI of 4:1.
Find out how much your company could save. Talk to us today!