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Network of
                                                                                            Networks
                                                                                            In 2011 HSM clients
                                                                                            paid 58% less than
                                                                                            their providers
                                                                                            charged!
Health Systems Managementis our proprietary “Network of Networks”
approach to provider access. This state of the art technology combines multiple             Cost Based Claims
HealthCare provider/networks to deliver “Assured Access” to HealthCare Providers            Negotiations
Nationwide. By overlaying the provider networks we can achieve access to more than
95% of all US providers that participate in any provider network.                           HSM utilizes a national claims
                                                                                            data base to successfully
In practice, most providers participate with multiple networks. This creates the            negotiate lower claims charges
opportunity for HSM to optimize the price paid for services. For each client, and within    and pay providers on a cost-
regions for clients with multi-state operations, a network hierarchy is developed and       based pricing model which has
used to determine which network will be applied when there are multiple choices             proven substantial reduction in
available. Therefore, in addition to offering increased breadth of access for patients to   dollars paid out on claims that
choose their HealthCare Provider, we also search for the lowest net cost to the health      are outside of the national usual
plan. For our clients, this approach delivers reduced costs and improves convenience        and customary pricing structures.
for members.

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Health Systems Management Flyer

  • 1. Network of Networks In 2011 HSM clients paid 58% less than their providers charged! Health Systems Managementis our proprietary “Network of Networks” approach to provider access. This state of the art technology combines multiple Cost Based Claims HealthCare provider/networks to deliver “Assured Access” to HealthCare Providers Negotiations Nationwide. By overlaying the provider networks we can achieve access to more than 95% of all US providers that participate in any provider network. HSM utilizes a national claims data base to successfully In practice, most providers participate with multiple networks. This creates the negotiate lower claims charges opportunity for HSM to optimize the price paid for services. For each client, and within and pay providers on a cost- regions for clients with multi-state operations, a network hierarchy is developed and based pricing model which has used to determine which network will be applied when there are multiple choices proven substantial reduction in available. Therefore, in addition to offering increased breadth of access for patients to dollars paid out on claims that choose their HealthCare Provider, we also search for the lowest net cost to the health are outside of the national usual plan. For our clients, this approach delivers reduced costs and improves convenience and customary pricing structures. for members.