Self-Funded
Health Plans. For
your company’s
self-interest.*

We offer a comprehensive, yet tailored, client-first approach to self-funded health plans, whether your business is local or nationwide. We’ll help you understand the implications of compliance requirements – specific to your business – so you can build the package that not only helps protect your company and plan members, but also helps optimize your investment.

Our Approach to Self-Funding*

We offer intelligent health – a smart, personal, and innovative approach to health care for self-funded health plans. It’s the combined management of three key aspects of health care: health, plan, and cost. Effectively balancing and optimizing these three components helps manage the health of a population, reduce cost by adding value, and improve the experience of accessing care. It’s an employer’s triple aim.

*AmeriHealth Administrators does not provide legal or tax advice. Please consult with your legal/tax advisor regarding your legal and tax obligations with respect to a self-funded plan.

Health Management

AmeriHealth Administrators can help plan members get healthy, stay healthy, and manage chronic conditions. Our clinical services team of registered nurses and trained health coaches uses claims analysis, biometric data, and personal health profiles to help develop interventions that best suit your population.

Clinical Services

We combine insight and compassion to help care for both the population and the individual. Our medical management programs help balance high-quality and cost-effective care, while helping to maximize the member’s overall health.

Wellness

Our suite of wellness program options allows you to customize a plan based on the needs of your population. And, as a result, can reduce health care costs and improve overall health.

Case Management

AmeriHealth Administrators has received Case Management Accreditation from NCQA for our Complex Case Management Program. Earning NCQA's Case Management Accreditation is an indication that a Case Management program is dedicated to care coordination, patient-centeredness and improving quality of care: getting the right care to patients.

Disease Management

We identify members with chronic or unstable conditions and provide them with education, support, and health coaching to help improve their outcomes – and help you better manage health care costs.

Health Utilization Management

AmeriHealth Administrators was certified by NCQA in Utilization Management1. NCQA Utilization Management Certification is a quality assessment program that focuses on consumer protection and customer service improvement.

Telemedicine

Enjoy convenient, 24/7 access to non-emergency care at lower costs than visits to an emergency room or urgent care center2. This virtual care delivery model enables secure consultations with a board-certified physician over a telephone, computer, tablet, or mobile app3.

1NCQA has reviewed and certified AmeriHealth Administrators' Utilization Management functions only. For complete details on the scope of this review, visit www.ncqa.org.
2Based on AmeriHealth Administrators' average contracted rates for an emergency room or urgent care visit.
3Telemedicine services are for nonemergency conditions only, subject to state regulations, and may not be available in certain states.

Plan Management

Our approach to health plan management is a customer engagement model that provides plan sponsors and their members with consultation, detailed reporting, and administrative support. It’s the human touch and consultation that translates the complex aspects of health care into digestible information that helps educate and improve the experience of accessing care.

Account Management

We know each client is unique, so we listen to you and then tailor programs to support your specific objectives. Our team measures the program’s success, and can recommend potential improvements to help increase your plan’s performance

Administration

Our dedicated implementation team helps to make the onboarding process easy. We walk you through the details, including eligibility, enrollment, and claims.

Intelligent Reporting

Using our intelligent reporting suite, we can help you evaluate plan design changes and other strategies that can help control costs and improve health.

Employer Resources

From our electronic data interchange services to our client support teams, we provide you with the resources to help you better manage your self-funded health plan – both online and off.

Member Resources

Being informed is one key to managing your health. So we provide 24/7 access to plan details and a wide-range of resources designed to help members do everything from finding an in-network doctor to living a healthier lifestyle.

 

Cost Management

We combine our clinical resources with our customer engagement model to help you design a plan that best fits your population and business objectives. We work with you to craft a health benefits plan that helps reduce costs by providing value through unique plan designs, incentive programs, and risk management vehicles.

Plan Design

Our comprehensive plan designs are tailored to meet your specific needs and bring the combined power of our experts and state-of-the-art technology.

Network Strategies

We connect you to health care providers locally and nationally, providing you access to high-quality care at a competitive rate.

Efficient Administration

Our fraud prevention safeguards help to identify duplicate claims, up-coding, and unbundling as well as incompatible procedures and diagnosis codes to help detect inaccuracies that can affect your bottom line.

Stop Loss

Stop Loss coverage helps protect you against high-dollar claims. And our preferred arrangement integrates with your self-funded health plan.

Connecting tomorrow with today

We reimagined our entire technology engine to better serve clients. This technology allows us to offer more comprehensive client services, enhanced interoperability, and improved health data management. What’s that mean to you? More options.

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The future of customer service is here

Success for customer service in the health care industry is often measured by the brevity of the call. At AmeriHealth Administrators, our customer experience advocates are measured by one thing: How helpful they are to you and your members.

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How can we help you?
Looking to learn more about how AmeriHealth Administrators can help turn the new health care landscape into your competitive advantage? Or have a question about your existing account? We can help. 1-800-984-5933 | sales@ahatpa.com

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