CBCA
Services
CBCA
combines integrated medical management strategies, seamless
service applications, innovative reporting, and predictive
modeling tools to deliver healthy clinical outcomes coupled
with measurable cost savings.
It’s
an approach that’s more effective, more customized,
more flexible and more efficient. It’s a process that’s
better integrated and better managed — with better results.
Plan
Administration
CBCA
Administrators Inc. is one of the largest independent benefit
management organizations in the U.S. The company has more
than 30 years of experience as an administrator of health
plans and a proven track record of delivering responsive service
and measurable results.
The CBCA advantage is in our automated processes, our thorough
understanding of benefit plan administration, our full service
offering, our commitment to advanced technology to manage
costs and enhance service, and our accountability.
Leveraging
three decades of health plan expertise, CBCA:
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Operates
a nationally licensed TPA operating through processing
and service centers across the U.S.
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Offers
flexible network management with access to national networks,
each of which includes more than 300,000 physicians and
3,000 hospitals, that have agreed to deliver care at competitive,
contracted rates. Out-of-network fee negotiation is also
available to generate savings at the point-of-care.
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Provides
and supports a comprehensive suite of supplemental services
including Flexible Spending Accounts, Reimbursement Accounts
for high-deductible health plans, Pharmacy Benefits Management
(PBM), Care Management, Short Term Disability, COBRA administration,
HIPAA compliance, Stop-Loss coverage, and Subrogation
options.
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Operates
a fully integrated call center and web self service suite
that delivers live, automated voice response, or web-based
service to employers, employees, dependents, and providers.
- Supports
customer administrative outsourcing needs through premium
billing, banking, financial services, and fulfillment.
How
We Serve Our Customers
CBCA’s
administrative systems and SAS70 Level II certified processes
provide the basis for the company’s payment accuracy,
responsive service, and cost efficiency. We are proud of our
performance and accountable for our results...so we work with
our clients to set targets and place up to 10% of our performance
fees at risk, based on meeting or exceeding those targets.
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Electronic
Data Interchange and Optical Character Resolution increase
speed and accuracy of claims processing with service standards
consistently at or above industry standards.
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24/7 Interactive Voice Response and Internet self-service
options successfully resolve more than 50% of all inquiries.
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More than 95% of claims are paid within 10 days.
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99.3% of FSA claims are paid within 3 business days.
Core
Business Operations
Care
Management
CBCA
Care Management includes a broad range of programs and services,
including Case Management, Utilization Review, a 24/7 Nurse-Line,
Disease Management and Wellness Programs. CBCA’s patient-centric
Care Management approach identifies potential gaps in care
through early intervention based on patient needs. Nurses
work with patients and physicians to determine the appropriate
level of care, care setting, number of inpatient days, and
follow-up or continuing care needs.
Pharmacy
Benefits Management
Through our strategic partnerships, CBCA offers innovative
Pharmacy Benefits Management plan options, customized formularies,
and integrated information systems to help coordinate care
and identify chronic disease conditions for early intervention.
CBCA’s customized program and integrated services give
members of the plan programs, a wide array of core products,
focused on driving down costs and advancing health.
Plan
Administration
CBCA gives plans unparalleled flexibility – the right
mix of funding arrangements, network solutions, flexible benefit
design and integrated services. Comprehensive CBCA administrative
services include our TPA Services and Reimbursement Plans.
Industry
Leading Products
CBCA leads the industry with these unique, innovative products
that help to effectively manage rising health care costs.
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Health
Quest™: CBCA is excited to offer this self-management
tool to our clients and their employees. The Health Quest™
product allows the employee to proactively control their
health care costs by early disease identification and
monitoring. An onsite health assessment and blood draw
is performed, and confidential results are back in the
member’s hands within 72 hours. Member results are
confirmed by a physician and enrollment in patient self-management
tool is assigned.
-
CareNavigator™:
CareNavigator™ is an advanced care management offering.
This product allows for coordination of healthcare activities
outside of the PCP setting. Several key components are
a 24/7 Nurse Help Line, Inpatient and Outpatient pre-certification,
Referral Management, Maternity Management, and Disease
Management (optional). Performance risk and reward pricing
is available.
- Roadmap™:
CBCA’s Roadmap™ product provides a focused approach
to managing costs at a member and disease level within a
population, by helping a client understand the illness burden
of a population. By using Roadmap™, a client can tell
who is at high risk for increased cost, what diseases are
present in a particular population, and what cost is associated
with the existing illness burden. This allows the client
to improve patient compliance with disease management programs.
In Summary
CBCA
has the size, technology, products, resources and innovative
ideas to successfully support your organizational objectives.
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