Benefit Administration
Apex’s flexibility and expertise allows you to develop a benefit package unique to your employees’ needs. We can help develop a customized product offering that best meets the current and future needs of your company.
Product Highlights:
- Accurate and timely claims administration using the latest technology
- Comprehensive, detailed reporting services available online
- Benefit design services
- Convenient online enrollment and claims information through Plan Central
- Knowledgeable and experienced Member Services representatives
- Access to national and regional PPO provider networks
- Efficient membership billing and eligibility verification
- Coordination of benefits
- Student eligibility verification
- Customized plan materials, including Member ID cards
Technology
Significant investments in industry-leading technology has allowed Apex Health Solutions to utilize a robust, state-of-the-art claims system, as well as an integrated predictive modeling application that incorporates medical and pharmacy claims.
In addition, our Case Management System incorporates utilization management, disease management and telemonitoring services to provide an integrated personal health record for members. This technology allows our care coordinators to see the whole picture when providing service to members.
Reporting
We are fully-committed to providing the most advanced reporting tools, giving you access to the information you need to help make decisions about your health plan. Targeted online reports allow pro-active management of your plan.
Examples of reporting available include Full Predictive Modeling, Group Risk Profile, Network Utilization and Discount, Group Claim Detail and Analysis, Medical Expense Detail, Group Lag Reports, COB Reports, Actuarial Summary Report and Analysis, Clinical Measure and Analysis, Pharmacy Detail Reporting, Pharmacy Analysis and Trends, High-Cost Claims or Claimants for Self-Insured and Group, Disease Management and Wellness and Tracking Reports (optional Services).