Network Design

 

 

Advantage Consulting Services, Ltd. specializes in the development and marketing of unique medical network management systems designed to improve the cost and quality of a company’s health program—combining accessibility and affordability. Along with network development, Advantage Consulting provides network, Payer and Provider auditing processes.

 

We consult with Third Party Administrators (TPA) to assess a network’s effectiveness for an employer group through the evaluation of metrics including geo-access, disruption analysis, and representative pricing reports. Advantage Consulting Services offer access to the highest quality and cost effective healthcare networks in Ohio and nationally. These networks will save Plans 30% or more on a net discount basis. This is accomplished through advanced technology, proven provider contracts, and the widest physician network access nationally.

 

In these demanding times and changing medical plan dynamics, rely on a talented team of consultants to steer your ship in the most efficient direction!

 

Analysis to Determine Network Value to Clients and Potential Clients:

Geo Access : Match employee zip codes to the network to determine provider accessibility
Disruption Analysis: Match current top provider utilization with the network to determine disruption (if any). Target non-participants for participation increasing discount yield
Repricing Analysis or Claims Repricing : Obtain claims and reprice them to determine the value of the network discounts.

We offer audit systems that review and analyze Payers, Providers, and networks to ensure accuracy of coding, diagnosis to treatment correlating charges, and network discounts to contracts. Our goal is to ensure accuracy and consistency of charges within the Plan, Provider, and Payer paradigm.