Coverage Is Key

Coalition America recognizes that effective managed care networks must service a
large area in order to meet the needs of members of any group who may live in
geographically distributed areas.

Although a primary network may have providers under contract within many states,
or perhaps even in all states, there still will be providers who are not "in-network" for
any given PPO. Members using these providers in their own hometown or while
away from home on travel subject their Plan to paying full retail price for services.
Although UCR may be useful in some cases to insulate the Plan from excessive
charges, UCR almost never reduces Plan costs to a managed care reimbursement
level.

Coalition America is able to analyze the population of a group given the demographics
of its members, and design the most effective quilt of PPO network coverage to ensure
best savings to the Plan with the least disruption to the members.

To do this, Coalition America needs access to many different national and regional
PPO networks. Often, regional networks may offer the best discounts for service in
their community and should be selected over national networks within that small
community, but clearly the national networks offer a larger scope that regional PPOs
cannot match. With over 100 PPO network relationships nationwide, Coalition
America is uniquely positioned to ensure the optimum coverage and savings
opportunities for your Plan and its members.

Our sophisticated algorithms can be used to determine the best match of PPOs in
each area needed to service your member base.