Claims Solutions – Weathering the Storm

AWAC® – Advanced Warning and Containment is now accomplishing in the healthcare arena what other companies merely dreamed of doing.

Bottom Line…It Works!!

With a track record of ten years AWAC® currently averages additional/incremental savings of $200 per year per covered life. So, for a company of 150,000 covered lives it translates to $30 million in savings per year!!

AWAC® has the answer with bottom line results using 21st century technology. AWAC® is a client service supported by more than 140 physician specialists who monitor a computer system that screens claims through over 60,000 medical and financial algorithms written by physicians. The system 'red flags' at risk patients, identifying catastrophic cases early, and recognizes fraud, abuse and errors in complicated cases. The physicians then implement programs to support the employee or negotiate down the cost of high claims.

Companies have always known that the greatest impact on a health plan's cost comes from large individual claims. For years, companies have made attempts to review these cases for fraud and abuse by utilizing either "in-house" or outsourced claims analysts. At times this has been effective, however, in a real sense it is like closing the barn door after the cows have run out and trying to find a few stragglers left behind.

Claims analysts simply do not have the expertise to identify catastrophic cases early, recognize fraud, abuse or errors in complicated medical cases, or effectively negotiate with providers from a pure cost basis.

The difference...

It takes a skilled physician, with hands-on experience in the specialty in question, to communicate with the attending physicians, manage expensive cases, review billing in a clinical context and negotiate claims. AWAC® was selected by the Center of Health Transformation as a technology that will change the future of health care in America!

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