HealthSmart Blog

Every year, HealthSmart surveys our health plan clients about their satisfaction with the quality of service we deliver to them and to their members. Last year’s survey results were very strong. We have just tabulated the results for the 2022 plan year, and we are delighted to report that respondents indicated an even higher degree of satisfaction with the service we provide to them. Even more gratifying, their willingness to recommend HealthSmart jumped significantly! Read More>>>

November is Diabetes Awareness Month and National Diabetes Month. Today, more than 100 million Americans are living with diabetes or prediabetes, according to the American Diabetes Association. The incidence of the disease is rapidly increasing. As the nation and the world prepare to focus attention on those living with diabetes and prediabetes, and celebrate the advances being made in the treatment of the disease, your clients should know about the range of services that HealthSmart offers to address this disease and its potential complications. Read More>>>

The Value of Integrated Care

10/11/2022 3:18:29 PM

Timely, accurate administration of claims is a minimum expectation of a TPA. But plan sponsors today need more than timely and accurate. They need cost reduction strategies that apply to their specific group and deliver good clinical outcomes with high member satisfaction. As one of the largest TPAs in the country, with over 500 clients, we process $6 billion of health encounter claims every year. Every one of those encounters creates a data touchpoint. Read More>>>

One of the most important services you can provide to your self-insured health plan clients is helping them choose the right Third Party Administrator (TPA). Understanding your client’s specific requirements and objectives is critical to creating a win-win relationship between your client and the TPA.  For some health plans, basic claims adjudication is all they need. For others, a full-service TPA that offers a comprehensive menu of products and services is the ideal solution. Regardless, the right client/TPA match can be the difference between smooth sailing or stormy waters for your client’s operations and their covered members’ experience. Read More>>>

In our recent Self-Insurance 101 blog, we reviewed the basic concepts of self-insurance and its underlying features and benefits. In this blog, we’ll dive a little deeper on how employers can efficiently and effectively transition from fully insured to self-insured and the key questions employers should address before setting out on the self-insured journey. Read more>>>

Over the past several years, there has been a steady increase in interest from brokers and employer groups in self-insured health benefits models. As more clients are evaluating their plan design, make sure they understand the fundamentals of self-insurance. Read more>>>

A new level-funded health plan is now available to North Texas and Houston employers thanks to HealthSmart, one of the nation’s largest third party administrators. DFW SmartCare and Houston SmartCare are comprehensive level-funded health plans that offer market-leading discounts to DFW-area and Houston-area small to mid-sized employers. Read More>>>

Even with the recent momentum toward price and cost transparency, as a self-funded health plan sponsor, do you know the true value of what you’re paying for? HealthSmart offers transparency resources like no other TPA. Do you know what’s changed and how those changes affect you and your members? HealthSmart keeps up on the latest revisions to federal regulations so when you partner with us, you don’t have to worry about being in the know and being compliant. Read More>>>

Plan sponsors are always looking for new ways to manage the cost of providing benefit plans while maintaining high member satisfaction. Reference Based Pricing (RBP), which reimburses hospitals and facilities based on a percentage of Medicare, offers an effective way to rein in hospital costs, but leaves the plan responsible for physician and ancillary charges. Members also often find the healthcare system complex to navigate, creating further dissatisfaction. SmartDecision, HealthSmart’s approach to Reference Based Pricing (RBP), offers a unique alternative. Read More>>>

There are many advantages to self-funding group health plans, but there are some large potential challenges, in the form of high unexpected claims, that can potentially threaten the stability of the plan. That’s where having the right stop loss partner is essential and having a plan administrator that can reduce the cost of caring for high-risk members becomes a critical success factor.  Read more>>>