Payers Solutions

Payers Solutions

Healthcare payers are facing the challenge of preparing for the changing healthcare environment in a very limited time brought about by various rulings on healthcare. Centro understands your need to transform their business model to successfully overcome these challenges.

We harness best practices and expertise across the continuum of care delivery to harness full potential in improving efficiency, customer satisfaction and retention, managing risk and compliance, and providing the agility necessary to compete.

Our Health Plans Solutions include:

Third Party Administration

Centro Healthcare’s innovative TPA services utilize the latest medical processing technology along with our distinctive healthcare cost-control approaches to provide you with the utmost advantages possible. We enable you to remain competitive and compliant in a system of continuously increasing costs and regulations.

In a healthcare system that’s flooded with fraught and inefficiencies resulting in fraudulent bills of $250 billion in unrecovered overpayments each year, Centro Healthcare is your solution!

  • Get control of your medical claims administration
  • Reduce your costs and loss ratios
  • Reporting system to monitor cost per claim and policy performance

Utilization Management

One of the biggest challenges facing the healthcare industry today is making sure people are getting the appropriate type of care as soon as possible. Centro Healthcare’s expert clinical staff focuses on just that: the right care at the right time! Utilization Management is a key factor in reducing cost while continuously improving the patient outcome.

Utilizing Centro Healthcare’s Solutions:

  • Reduces costly clinic and hospital visits
  • Keeps patients and physicians up-to-date with current patient conditions
  • Physicians and organizations can easily monitor the data collected to identify developing or worsening conditions without having to schedule frequent office visits
  • Costs are reduced and Patient’s healthcare status is constantly updated

Download our Utilization Management brochure here.

Medication Therapy Management

Centro Healthcare is your helping arm in reaching and achieving these goals by targeting people who take multiple prescription medications and who in many cases suffer from multiple chronic diseases. We work with you to keep your patients out of emergency rooms, decrease hospitalizations and readmissions and improve their health outcomes. Our data-driven solutions give you the actionable insights to achieve your goals.

Our highly trained and certified care coordinator will guarantee the following:

  • Engage the patient
  • Increase medication adherence
  • Educate the patient of their disease

Centro Healthcare assists you to avoid excessive usage and under-use of medical services by supporting you in making clinical coverage decisions based on available evidence-based guidelines.

Consult us Today!