Healthcare cost containment measures have become a necessity with double-digit
medical inflation, skyrocketing drug costs, along with the inherent risk of
self-insuring and expanded reporting requirements. Healthcare cost containment
by TC³ (Total Claims Capture & Control) provides health care payers with a
total claims management solution that seamlessly and electronically integrates
internal claim management systems with external loss control programs.
Utilizing our proprietary claims management system, the TC³ Funnel, we target
$250 billion in healthcare claims overpayments, to validate payment integrity
and maximize cost savings for our clients. TC³ enables our payer clients to
take advantage of multiple state-of-the-art loss control technologies through a
single connectivity source to prevent paid claims errors on a pre-payment
basis, reducing paid claims by 3-6% annually. TC³ can design a customized
healthcare cost containment program that addresses each client’s unique needs.
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Reducing healthcare claims expense by identifying areas of potential fraud,
abuse or overpayment is a key element in cost containment. TC³ provides
analysis tools to generate actionable information in managing healthcare cost
and risk. Our cost containment measures are based on data-driven analytics that
accurately identify inappropriate activity, and accelerate payment for claims
that should be paid.
A critical factor in overall healthcare cost containment is generating savings
wherever possible. TC³’s AccessPlus PPO Network and Provider R&C
Negotiations increase savings for payers without changing plan design or
benefit differentials. These tools are designed to supplement out-of-area
coverage to address network gaps with existing provider networks and reduce the
cost of out-of-network claims.
TC³’s integrated healthcare cost containment solutions are designed to
prospectively reduce overall paid medical claims exposure by 3–6%, while
improving payment integrity and operational efficiency.
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