Interaction with Stop Loss

Our nurses and certified case managers use a flexible information management system that supports collection and management of patient information, and retrieval and tracking of medical case and claims information. The integration of this data gives our specialists client-specific information, including enrollment and eligibility, medical benefits and exclusions, pre-certification requirements, network affiliations, and any special instructions they need to render determinations in a time sensitive manner. It facilitates accuracy and consistency in quality of care coordination, collaboration, communication and reporting.

Within 24 hours of confirming a patient’s diagnosis matches a diagnosis on the stop loss carrier’s trigger diagnosis list, a large case notification is sent to the client’s stop loss carrier.

 

Feel free to contact us about our service anytime by e-mail at info@ameriben.com or call toll free at 1-800-786-7930

Integrity-Initiative-Good Judgment-Teamwork