Our Service-First Approach
Respect, kindness, understanding, and humility—these are the values that drive our team to deliver quality TPA services to our clients. Our team of experts guides clients through self-funded, level-funded, Per-Pay-Period Administration (P3), and minimum essential coverage (MEC) benefit plans. Be our guest and receive:
Average Customer
Service Response Time
Claims Processing
Accuracy Rate
Claims Processing
Turnaround Time
Delivering impactful solutions lets us place emphasis on our service offerings.
CLAIMS PROCESSING
Claims administration is a TPA’s bread and butter! At Concierge, we handle the following:
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Verifying eligibility
-
Determining coverage
-
PPO repricing
-
Adjudicating claims based on terms of benefit coverage
PROVIDER NETWORK MANAGEMENT
Concierge establishes and maintains networks of healthcare providers, including doctors, hospitals, and other medical facilities, and manages the following:
-
Negotiation of contracts
-
Settling reimbursement rates
-
Ensuring access to quality healthcare services
CUSTOMER SERVICE
Concierge offers customer support services to policyholders through our dedicated call centers and online portals, and assists with the following:
-
Claims
-
Coverage
-
Benefits
-
Other policy-related matters as needed
PHARMACY BENEFIT MANAGEMENT
Similar to our Provider Network Management service offering, we establish and maintain networks of pharmacies and manage the negotiation of contracts, reimbursement rates, and access to quality care. Our networks include mail-order pharmacies, offering lower out-of-pocket costs for many benefit plans.
COMPLIANCE AND REGULATORY SUPPORT
We stay up to date on regulations and compliance requirement changes. We assist with the following:
-
Managing documentation
-
Privacy regulations
-
Compliance-related aspects of claims administration
REPORTING AND ANALYTICS
Our team generates reports to provide insight into claims data, trends, and utilization patterns. This helps employers:
-
Assess healthcare costs
-
Identify areas for improvement
-
Make informed decisions
WELLNESS PROGRAM
Concierge receives and processes files from Wellness vendors. The team also manages the adjudication of wellness claims and member Explanation of Benefits (EOB).
COORDINATION OF BENEFITS
In cases where an individual has multiple insurance policies, our team can help determine the primary and secondary insurance policies to avoid overlapping coverage and expenses.
CLAIMS PROCESSING
Claims administration is a TPA’s bread and butter! At Concierge, we handle the following:
-
Verifying eligibility
-
Determining coverage
-
PPO repricing
-
Adjudicating claims based on terms of benefit coverage
PROVIDER NETWORK MANAGEMENT
Concierge establishes and maintains networks of healthcare providers, including doctors, hospitals, and other medical facilities, and manages the following:
-
Negotiation of contracts
-
Settling reimbursement rates
-
Ensuring access to quality healthcare services
CUSTOMER SERVICE
Concierge offers customer support services to policyholders through our dedicated call centers and online portals, and assists with the following:
-
Claims
-
Coverage
-
Benefits
-
Other policy-related matters as needed
PHARMACY BENEFIT MANAGEMENT
Similar to our Provider Network Management service offering, we establish and maintain networks of pharmacies and manage the negotiation of contracts, reimbursement rates, and access to quality care. Our networks include mail-order pharmacies, offering lower out-of-pocket costs for many benefit plans.
COMPLIANCE AND REGULATORY SUPPORT
We stay up to date on regulations and compliance requirement changes. We assist with the following:
-
Managing documentation
-
Privacy regulations
-
Compliance-related aspects of claims administration
REPORTING AND ANALYTICS
Our team generates reports to provide insight into claims data, trends, and utilization patterns. This helps employers:
-
Assess healthcare costs
-
Identify areas for improvement
-
Make informed decisions
WELLNESS PROGRAM
Concierge receives and processes files from Wellness vendors. The team also manages the adjudication of wellness claims and member Explanation of Benefits (EOB).
COORDINATION OF BENEFITS
In cases where an individual has multiple insurance policies, our team can help determine the primary and secondary insurance policies to avoid overlapping coverage and expenses.
Concierge is committed to delivering top-of-the-line service.
Still not sure if our options are right for you?
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