Devon Health Wire June 2010 - Volume 1, Issue 1

Welcome to the Devon Health Wire -
Our New Client Newsletter

Welcome to the Devon Health Wire! The purpose of this newsletter is to keep you informed on the happenings around Devon Health, new services and solutions that will better serve you, and tips on keeping your members healthy. We are committed to staying in touch with our clients and providing you with the best service possible. We want to empower you to make the best decisions possible for the welfare of both your company and your members. As your choice for your managed care vendor, Devon Health’s sincere hope is to offer you full service solutions that lower costs.

As always, please feel free to contact us if you have any questions about your services or if there is a way that we can better serve you. Your account manager is always available to any questions, issues or concerns that you might have. If you are unsure as to whom your account manager is, please feel free to email clientservices@devonhealth.com and your manager will respond to you shortly.

Devon Health Introduces New
Cost-Containment Service

Consilium Logo

Here at Devon Health, we are constantly striving to exceed the expectations of our clients by developing solutions that combat rising healthcare costs.

Consilium, our recently launched healthcare cost-containment service, is our latest cost solution. Consilium uses groundbreaking techniques to help control and lower healthcare costs through claims negotiation and bill review. Boasting a team of expert negotiators and a visionary process, Consilium is helping clients receive discounts averaging well above the industry norm. Consilium’s highly successful claims settlement service boasts up to a 70% success rate and an average of up to 40% savings on out-of-network healthcare claims, nearly double the standard average.

The Consilium approach to claims management and discounting is a more resourceful method in managing out-of-network claims and cutting costs without the risk involved in more traditional methods. Utilizing benchmarks that reflect what providers normally accept from local, regional, and national payers, Consilium takes the focus off of the billed charges and places it where it should be, fair market reimbursement for providers.

For more information on Consilium and how it could help your organization, visit asmarterapproach.com to watch a 60-second video tour or to schedule a private webinar with one of our expert claims representatives.

You can also follow smarterapproach on Twitter.

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Devon Health Offers National Access

USA Map

To fulfill the needs of our multi-state clients, Devon Health has developed an extensive national network of PPO partners. This network reflects the "best of the best" in network access, discounts, and service, a combination that is not available through any other cost management company. We can offer our clients a seamless national solution, along with customized reporting, re-pricing capabilities and electronic connections with many of our partners.

By strategically aligning ourselves with key industry players, Devon Health is able to:

  • Offer seamless networks nationwide
  • Reduce healthcare costs
  • Provide superior customer service
  • Simplify administrative and technical processes

For more information on how you can access our national network, please contact your account manager, or email us at clientservices@devonhealth.com.

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Your Customizable Service Options

Devon Health takes pride in being able to offer customized services at an optimal level. It is our aim to assist you as much as possible. Customized reporting is a service option that is managed in-house and can also be set up to be viewed remotely through our secure client portal. Our flexible reporting package can be tailored to enable us to provide you with exactly what you want, without any additional administrative burdens for your organization. This puts the power of your account data at your fingertips, allowing you greater control and empowering you with the information that you need, when you need it.

Electronic-Data Interchange (EDI), which significantly reduces re-pricing errors and improves claim turnaround time, is a service option offered to make administrative processes more efficient. Customized re-pricing solutions and flexible electronic connections also enable us the opportunity to make our company fit with the needs of our partners, and bring re-pricing turnaround times down to 48 hours or, in most cases, 24 hours or less. This service option affords us the opportunity to work both regionally and nationally; making re-pricing an easy and accessible option for anyone. Of course, we understand that EDI may not work for everyone, which is why we offer different connection types to suit your needs.

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New Flexibility with Directory Requests

Devon Health is in the process of developing a new method of producing electronic provider directories for our clients. In the past, our Devon Health provider directories were solely based upon the general regions in our network footprint, as opposed to being specific to a certain area. With the new method, our clients can now choose any county from any state in our network to be compiled into a customized provider directory. This empowers you, our client, with the flexibility to tailor the directory to the needs of your existing and prospective groups.

Devon Health’s Client Services team can generate an electronic directory within three business days and send, via email, back to you. Please reach out to your Client Account Manager for more details and information. Please note that we will continue our policy of not providing directories (even in electronic form) directly to members.

Members may continue to print out their own customized directory from our Provider Finder at www.devonhealth.com, or can talk with their internal Human Resources Department for their directory needs.

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Changes to HIPAA, HITECH Act Top Priority for Devon Health

The American Recovery and Reinvestment Act of 2009 and the HITECH Act included changes to HIPAA compliance that included a clause for business associates. In recognition of the changes to HIPAA as a result of the HITECH, and more specifically the new clause for business associates, Devon Health has been working diligently to update our internal HIPAA compliancy standards. We recently sent out correspondence to our existing clients with whom we share PHI regarding these changes and updated contracts that are necessary.

Devon Health has updated its internal educational program for employees to ensure that these legislative changes are adhered to. Our staff is trained on the new HIPAA HITECH standards and regulations to keep them up-to-date on the changes implemented. Our clients’ privacy is of utmost importance, and we are doing everything we can to ensure that your information is protected.

If your organization has any questions regarding Devon Health’s adherence to HIPAA compliancy, please let us know by sending us an email to clientservices@devonhealth.com.

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Prompt Pay Clause Bulletin

Although the majority of our clients pay member claims both efficiently and accurately, it should be noted that because of the current economic climate, many of our providers are more consistently enforcing prompt pay requirements in their network participation agreements. All Devon Health clients should pay member claims to participating providers within 30 days of receipt of a claim in order to ensure acceptance of the network discount.

From time to time, your Client Account Manager will send out information on specific facilities’ arrangements; however, no provider contracts contain terms stricter than 30 days. If you have any questions about specific providers, please feel free to contact your Client Account Manager.

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Health Thoughts - What's the Big Deal About Wellness Programs?

There seemed to be a trend several years ago with workplace wellness. The noticeable increase in wellness programs in the workplace may have had a few people scratching their heads. As time has gone by, not only have the wellness programs in corporations across the country increased in number, but there appears to be a very good reason why: wellness programs have significant potential to decrease healthcare costs, reduce employee absenteeism and improve productivity.

Studies indicate that many companies spend 50% of profits on employee healthcare, up from 7% a mere 30 years ago. One of the reasons that wellness programs are so effective is that they focus on preventative care. Since 90% of all healthcare costs are from preventable diseases, proactive care is essential to lowering costs. Healthcare costs are clearly driven through the roof when illnesses emerge that could have been prevented through exercise and proper nutrition.

If wellness programs are returning positive results, why aren’t more companies adopting them? Possibly because it seems cost prohibitive to do so. However, a study done by Highmark showed their internally implemented wellness program produces an ROI of $1.65 for every dollar spent on implementing their wellness program.

Under the recently passed Patient Protection and Affordable Care Act, employers can offer incentives for employees to take part in company-sponsored wellness programs. This move will hopefully encourage companies to promote employee wellness even further.

It is important that employers encourage their employees to take more responsibility for their health and wellbeing. Consider implementing a wellness program at your organization, or let us know what you are already doing to improve employee health!

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