Comparative Analysis Partner Pricing

$4,999 per year

• Access to our proprietary discovery session designed to collect all necessary information required
• Dedicated account manager
• Entering into a Business Associate Agreement (BAA) thus allowing our team to collect and review medical and pharmacy claims as needed
• Review of plan information, plan financials, administrative service agreements and plan documents
• Standard pricing assumes analysis of one third party administrator (TPA) arrangement, one pharmacy benefit manager (PBM) arrangement, one medical plan network, one medical management and utilization review vendor and up to three different medical plans. If the Client organization has more vendors than this, they can be added to your standard package for an additional fee.
• Delivery of .pdf version of your plan Assessment Tool report to meet the “show your work” requirements
• The Assessment Tool will include full analysis of broad plan limits.
• The Assessment Tool will include analysis of quantified treatment limitations (QTLs), including applying the substantially all and predominant tests to the necessary classifications and sub classifications of expected, future plan claims.
• The Assessment Tool will include analysis of non-quantified treatment limitations (NQTLs), including but not limited to a review of medical management standards, exclusions for medical necessity, standards for categorizing care as experimental, prior authorization, concurrent review, network tier decision criteria, standards for network participation, formulary design, comparative provider reimbursement rates, comparative provider reimbursement rates as a percentage of Medicare, plan exclusions, plan restrictions and plan limits on duration of services.