WE MAKE A DIFFERENCE
OUR SERVICES
The greatest sports teams of our generation use analytics to create a winning edge against their competition — why then shouldn’t we? The key to controlling costs and improving outcomes is being able to put data to work. Benveo provides self-funded clients with the most up-to-date claims reports, fund analysis, and plan utilization to leverage knowledge in a meaningful way. Customizable plans and reporting are what make Benveo’s professional analysis state of the art—we’re versatile enough to give employers what they crave: control.
The Benveo™ Advantage
Paying claims is only the beginning!
Account Management Team
■ Client Service Representative to ensure a smooth, timely implementation and remain the single point of contact for PBM and other vendors’ inquiries, report requests, and government compliance
■ Enrollment Specialist to assist with questions related to enrollment, eligibility, COBRA, and Flex
■ Account Manager for ALL claim processing needs and questions from the
Plan Sponsor Customer Service
■ Customer Service Unit staffed by in-house, full-time Benveo employees
■ Member Website
■ Innovative Mobile Apps
■ Multilingual customer service capabilities
■ All calls completely documented with first call resolution rate over 98% - remaining resolved within 48 hours
Health Claim Administration
■ Maintenance of plan eligibility with personalized ID card services
■ In-house developers for daily Electronic Data Interchange (EDI) management of imported and exported data files (fees may apply if PBA has to develop a new vendor connection)
■ Daily claim adjudication for Medical, Dental, Vision, Short Term Disability, Consumer Directed Health Plans – FSA, HDHP with HSA and/or HRA, and COBRA
■ Print ready standard Benveo Plan Document/Summary
■ Plan Documents and SBCs
■ Preferred Provider integration to maximize discounts by region
■ Prescription drug management programs
Plan Cost Management
■ Managed care alerts for early managed care engagement
■ Strong pre-certification, utilization review, and care coordination programs
■ Predictive modeling helps identify and manage chronic conditions
■ Specialty condition management programs like cancer, transplant, and dialysis (additional fees may apply)
■ Bill review and out-of-network provider discounting (fees billed as a % and paid as a claim)
■ Proactive identification of subrogation opportunities (additional fees may apply)
■ Pre-emptively manage plan member eligibility
■ Application of stringent adjudication controls and edits ■ Monthly detailed reporting
■ Health plan cost analytics for plan design
Governmental Compliance Services
We take the burden of regulatory compliance off the shoulders of employers by:
■ Reviewing all plans for compliance under ERISA, HIPAA, ACA, and other regulatory changes.
■ Providing guidance in making the plan compliant
■ Issuing timely notices of regulatory changes and upcoming compliance deadlines
■ Assisting with regulatory reporting to facilitate the payment of fees and taxes
■ Sponsoring regulatory training sessions