Corp Overview


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HealthSmart provides integrated benefit solutions, on a single administrative platform, through its wholly-owned healthcare related subsidiaries. Our mission is to improve member health and reduce costs.

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Corp Overview

  1. 1. Overview to Smarter Health Benefits
  2. 2. Our Vision <ul><li>To be the healthcare industry’s leading provider of innovative solutions. </li></ul><ul><li>To provide our clients with the highest quality healthcare solutions utilizing the latest technology and a resourceful team of professionals focused on reducing costs and improving members’ health. </li></ul>Our Mission
  3. 3. <ul><ul><li>Totally Integrated & Innovative Healthcare Management Organization </li></ul></ul><ul><ul><li>Over 700 Professional Healthcare Team Members Located Across the Country </li></ul></ul><ul><ul><li>Privately Held Company With Revenue Over $140 Million </li></ul></ul><ul><ul><li>Providing Innovative Solutions to Over 8,000 Employer Groups Nationwide </li></ul></ul><ul><ul><li>Partnered With Over 520 Other Healthcare Benefit Administrators </li></ul></ul><ul><ul><li>Serving More Than 1,850,000 Members </li></ul></ul><ul><ul><li>Managing Over $3.2 Billion in Claims Annually </li></ul></ul>Corporate Overview
  4. 4. <ul><li>Fully-Integrated Healthcare Solutions </li></ul><ul><li>Employer Benefit Services </li></ul><ul><li>Preferred Provider Network Solutions </li></ul><ul><li>Care Management & Wellness Programs </li></ul><ul><li>Prescription Benefit Management </li></ul><ul><li>On-Site Primary Care Clinics </li></ul><ul><li>Reinsurance & Risk Management Solutions </li></ul><ul><li>Information Technology Systems </li></ul>Our Smarter Solutions
  5. 5. Think Smart, Act Smart- Our Family of Services
  6. 6. <ul><li>Medical, Dental & Vision Administration Solutions </li></ul><ul><li>Preferred Provider Networks </li></ul><ul><li>Care Management & Wellness Programs </li></ul><ul><li>Prescription Benefit Management </li></ul><ul><li>On-Site Primary Care Clinics </li></ul><ul><li>Comprehensive Reinsurance & Risk Management </li></ul><ul><li>Information Technology Systems </li></ul>Fully-Integrated Healthcare Solutions Employer Benefits on a Single Platform for Maximum Flexibility & Savings
  7. 7. <ul><li>Primary PPO Networks </li></ul><ul><li>Customized Networks </li></ul><ul><li>Secondary/Wrap Networks </li></ul><ul><li>Regional & National Affiliate Providers </li></ul><ul><li>Specialty Care Networks </li></ul><ul><li>Dental Networks </li></ul><ul><li>Workers’ Compensation Networks </li></ul>Preferred Provider Network Solutions Significant Cost Savings From Quality Healthcare Providers
  8. 8. <ul><ul><li>Utilization Review </li></ul></ul><ul><ul><li>Case Management </li></ul></ul><ul><ul><li>Predictive Modeling </li></ul></ul><ul><ul><li>Disease Management </li></ul></ul><ul><ul><li>Transplant Management </li></ul></ul><ul><ul><li>Maternity Management </li></ul></ul>Care Management Solutions and Wellness Programs <ul><ul><li>Non-network Negotiations </li></ul></ul><ul><ul><li>Wellness Coaching </li></ul></ul><ul><ul><li>Nurse Advice Line </li></ul></ul><ul><ul><li>Integrated Reporting </li></ul></ul><ul><ul><li>URAC Accredited Since 2002 </li></ul></ul>Minimizes Cost & Improves Members’ Health
  9. 9. <ul><ul><li>Nationwide Network with Over 60,000 Participating Pharmacies </li></ul></ul><ul><ul><li>Brand Name, Generic and Mail Order Pricing Options </li></ul></ul><ul><ul><li>Generic and Brand Formulary Options </li></ul></ul><ul><ul><li>Online Accumulators, Out-of- Pocket Tracking & Claims History </li></ul></ul><ul><ul><li>User Friendly Reports </li></ul></ul>Prescription Benefit Management Transparent Solutions That Control Prescription Program Costs
  10. 10. Employer Benefit Services <ul><li>Premium Billing/Payment Administration & Eligibility Management </li></ul><ul><li>Online & Automated Enrollment Services </li></ul><ul><li>Brokerage Operation Services </li></ul><ul><ul><li>Form 5500 Preparation </li></ul></ul><ul><ul><li>COBRA/HIPAA Administration Services </li></ul></ul><ul><ul><li>FSA/HRA/HAS Administration Services </li></ul></ul><ul><li>Medicare Claims Administration Services </li></ul><ul><li>Complete Suite of Online Reporting & Analytic Services </li></ul>Comprehensive Health Plan Solutions on a National Scale
  11. 11. Employer On-Site Primary Care Clinics <ul><ul><li>Primary & Occupational Care for Employees & Dependents </li></ul></ul><ul><ul><li>Staffed with Licensed Physicians & Medical Professionals </li></ul></ul><ul><ul><li>Supports Disease Management, PBM & Wellness Initiatives </li></ul></ul><ul><ul><li>Healthcare Costs Reduced by Eliminating Layers of Administration </li></ul></ul><ul><ul><li>Reduces Employee Absenteeism </li></ul></ul>Reduces or Eliminates Healthcare Inflationary Trend
  12. 12. Reinsurance & Risk Management <ul><ul><li>Products Backed by Highly Rated Carriers </li></ul></ul><ul><ul><li>Preferred Partners Who Have Evaluated HealthSmart’s Managed Care Tools </li></ul></ul><ul><ul><li>Our Partners Deliver the Most Competitively Priced Solutions in the Market </li></ul></ul><ul><ul><li>Traditional Specific & Aggregate in All 50 States </li></ul></ul><ul><ul><li>Creative Solutions to Help Manage Our Clients’ Risk </li></ul></ul>Reduces Financial Exposure & Premium Expenses
  13. 13. Information Technology Systems <ul><ul><li>Complete Electronic Data Interchange (EDI) Clearinghouse Services </li></ul></ul><ul><ul><li>Back Office Functionality with PPO Repricing Services </li></ul></ul><ul><ul><li>Scanning & Optical Character Recognition (OCR) of Paper Healthcare Claims </li></ul></ul><ul><ul><li>Conversion to Electronic Claim Format </li></ul></ul><ul><ul><li>Electronic EOB/Payment Fulfillment </li></ul></ul><ul><ul><li>Customized Programming & IT Support </li></ul></ul>Streamlines Electronic Processing
  14. 14. Please Contact Us for Additional Information Thank You for Visiting