No one understands this more than Joe Toscano, chief financial officer of Benefit Administrative Systems LLC, a national third-party administrator based in Homewood, Ill. BAS administers the employee benefits programs for more than 300 employer groups covering 75,000 employees, representing companies with anywhere from 25 to 4,500 employees.
"In today's changing world of healthcare, our goal is to design and manage employee benefits plans that are not only cost-effective for the employer but that meet the ever-changing needs of the employee and their family," says Toscano.
In an effort to control and contain costs, while reducing administrative expenses, BAS provides utilization review, large case management and disease management services, prescription drug card administration, and access to multiple local, regional and national PPO networks.
"Our focus is largely on disease management and early detection and management of chronic illness," stresses Toscano.
As part of its commitment to keeping clients' employees healthy, BAS provides access to on-site screening services and on-site physicians at employers' operations.
"Placing a physician on-site and providing on-site screening for annual lab tests helps remove hurdles to care and encourages employees to use their healthcare services," he says.
As part of its commitment to steering individuals to the appropriate care at the appropriate time, BAS works closely with its medical technology partner, VIIAD Systems LLC of Langhorne, Pa., to provide patients with a gateway to their healthcare information.
Using VIIAD's technology, employees are able to go online to the BAS Web portal to search for a healthcare provider and print an automated Health Ticket, which serves as a health care ID card that identifies all of their pertinent benefits information. Similar to an airline eTicket, the Health Ticket contains personalized, member-specific information such as co-pay instructions, deductibles, provider information, precertification requirements, and claims submission and pharmacy benefit information.
In addition, the Health Ticket clearly states whether a chosen provider is in or out of network, so employees can obtain the proper authorization prior to visiting a doctor.
"This technology gives patients, payers and providers access to healthcare information on an on-demand basis," says John Zubak, chairman and CEO of VIIAD, which stands for Virtual Interactive Identification and Direction. "The Health Ticket becomes a virtual insurance card that improves compliance, eliminates fraud, and provides administrative savings to providers and physicians and offers simplicity for patients," he notes.
"The Health Ticket allows employees to get a quotation of benefits, identify whether their healthcare provider is in or out of network, verify their eligibility and generate their own personal health record," says Toscano. "In addition, our on-site physicians can use the Health Ticket as a scheduling and referral tool when sending employees to specialists."
Employees can use the Health Ticket as a referral tool to schedule age and gender-appropriate screening tests, such as annual blood work, cholesterol testing and other screening tests at local laboratories.
In addition, BAS has a relationship with Triveris Inc., an Eatontown, N.J.-based healthcare technology company that offers an online personal health record with a built-in personal health advisor. The online health record automatically captures the employee's lab results, health history, pharmacy records and claims data; identifies potential health risks based on this information; and recommends appropriate actions for staying healthy.
"The VIIAD and Triveris technologies were a natural fit for our proactive approach to healthcare management," says Toscano. "VIIAD provides a gateway to steer patients to the appropriate care in the appropriate setting, and Triveris generates a health record that allows individuals to take a proactive approach to managing their healthcare--addressing ordinary ailments before they turn into life-threatening diseases."
Physicians can also use the Health Ticket as a tool to verify patients' eligibility and quotation of benefits. BAS also has a relationship with RedCard, a recognized, branded healthcare ID card, whose logo is embedded into every Health Ticket that an employee prints out.
BAS is in the process of rolling out its updated, technology-based benefits programs for its January renewals, and should have its entire client base up and running by the first quarter of 2009.
"The integration of employees' benefits information has been well received by our clients," says Toscano. "The ability to steer employees to network providers and create an ongoing health record is an attractive benefit and will help strengthen our focus on wellness, prevention and early detection of chronic illness in order to implement disease and lifestyle management programs."
piece is part of our continuing Insights series designed to highlight key products and services to our readers. This paid-for
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December 3, 2008
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