Association Health Care Management, Inc. has maintained our own TPA license giving us an advantage when maneuvering through the intricate healthcare system. With this, we have helped program managers, insurance carriers, benefit providers and associations develop and implement a variety of healthcare solutions. AHCM provides member assistance through our customer support team, in-house fulfillment operation and access to a unique member portal with details about their plan.
Association Member Management
Providing services and solutions to Associations, including customer service, administrative assistance, and strategic management solutions.
Patient Advocacy
Providing open and effective lines of communication between the patient and the healthcare provider, so the patient has a voice in the decisions made about their health care.
Insurance Plan Designs
Providing value-based insurance designs to generate and provide consumers with quality and cost-efficient health care services and devices.
Third Party Administrator
Providing back-office services that all your company is functioning more efficiently and effectively. Services include payment collection, enrollment management, and more.
Consulting Services
Providing consulting services in the areas of compliance, product fulfillment, customer support, and back office management for your company and third-party members to support growth and sustainability with customers and consumers.
High-Touch Case Management
Our case managers support employers at every step of the process, so they can focus on their business and employees can focus on their well-being.
- A dedicated case management team
- Customizable plan designs, including high-performance networks with financial incentives to drive utilization and minimize costs
- Preferred stop loss vendors with superior pricing based on the underwriting methodology
Claims Administration
We deliver seamless claims administration with speed and accuracy, ensuring efficient resolutions and exceptional support for our customers.
- In-house utilization management
- Disease management team that reviews and adjudicates each claim for accuracy and medical necessity
- Dashboard that provides metrics to measure trends and project future exposure
- A system that captures payroll deductions and eligibility reconciliation for stop loss, reinsurance, and any ancillary providers of additional benefits
Utilization, Financial Reviews and Recommendations
We are stewards of your business and care for your employees' well-being.
- Multiple premium funding programs, including options for employer participation
- Utilization and disease management to help contain costs
- Modern underwriting processes that produce faster results, reducing the need for health questionnaires or, for groups under 150 eligible employees, reducing the need for claims experience for rate development
- Predictive Modeling that helps deliver the best care, minimizing financial burdens
Connected Technology
We use our proprietary technology to move quickly, and our expertise helps resolve issues that are out of the ordinary, giving our customers the best care possible.
- We utilize cutting-edge technology to operate with speed and precision.
- Our expertise ensures effective resolution of complex and uncommon issues.
- We prioritize delivering the best possible experience and support to our customers.
- Continual innovation drives our ability to adapt and improve for customer success.
Ready to Get Started?
Contact us today to learn how our services can benefit your organization.
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