SERVICES: Questionable Providers   Claim Editing   Primary Networks   Network Management
SERVICES:Secondary Networks   Disease Management   Fraud, Waste, & Abuse   Repricing Technology
SERVICES:Reporting   Workers’ Compensation   Customer Service  
 
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Primary PPO Network Management Services

CAI provides access to over 100 PPOs nationally. We utilize ZIP code, provider tax ID numbers, and claims information to analyze each client's PPO needs and make recommendations on the best Primary PPOs for coverage AND savings.

As a result, CAI will be able to provide:

  • PPO selection by state, including provider counts
  • Combined GeoAccess reports and mapping reflecting all PPOs recommended
  • Savings analysis reflecting anticipated in-network and out-of-network savings by state
  • Internet and EDI repricing services (including negotiations)
  • One stop solution for in-network and out-of-network medical bill repricing
  • CAI then manages the relationship with the PPOs and providers freeing your resources for other key projects and services

RESULT: Greater in-network savings, fewer claims out-of-network, and enhanced employee satisfaction.

 
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