employee health plans


Employee healthcare benefits are becoming very complex. Many companies face the challenge of offering competitive medical benefits that encourage a healthy lifestyle while trying to contain costs.

Patient Advocates is redefining health care by helping employers foster a culture of wellness while empowering plan participants to make decisions based on their best value, just like they do in other areas of their lives. Put simply, we empower employers and plan participants to make decisions based on better care while reducing unnecessary spending.

Crafting the Right Plan

Most insurers provide off-the-shelf options that are easy for them to market but are not the best fit for all companies.

At Patient Advocates, we take a different approach. We recognize that every employer and its employees have their own needs, and our experienced team works to tailor health plans to reflect the demands and opportunities of individual organizations.

Patient Advocates will work closely with your group to design a health plan that meets your strategic financial goals, while providing optimal health care choices for plan participants. By offering incentives to use both centers of medical excellence and preventive care while managing chronic conditions, your health plan will outperform that of your competitors from a cost-containment standpoint while empowering your plan participants to make informed health care decisions.

Efficient Benefits Administration

Employers often can save significant amounts of money and run more effective health care plans by self-insuring their health plan.

To make this option work, however, the organization needs a partner who understands the complexities, pitfalls, and opportunities that characterize today’s health care system.

Patient Advocates has the experience, work ethic and skilled staff to carefully and effectively provide third-party benefits administration to self-insured organizations. Our services include:

  • Claims Administration
    • Claim Edit System
    • Integrated Claims Software
    • Provider Fee Schedules
    • Provider Network Participation
    • Subrogation
    • Reasonable & Customary Profiles
    • Claim Edit System (CES)
  • Eligibility & Enrollment Services
  • COBRA/HIPAA Management
  • Section 125/FSA Administration
  • Health Reimbursement Arrangements
  • Network Access Integration
  • A proprietary Value-Based Network
  • Reference Based Pricing Platforms
  • Pharmacy Benefits Management Integration
  • Plan Document and SPD Preparation
  • Integrated Reporting Suite

In addition, we provide reports that analyze plan performance related to topics such as per-claimant cost, per-benefit cost, high-risk claimants, top providers and payments by benefit categories. Patient Advocates designs a personalized reporting package to meet the needs of individual organizations, making sure that they have a full understanding of what reports will be used and their frequency.

Because Patient Advocates both administers plans and provides wellness services, we have the unique ability to determine a return on investment for that program. These reports show you how quickly your investment in employee wellness starts to pay dividends.

If you are looking for a partner you can trust to administer your self-insured health plan, think of Patient Advocates and call us at (800) 290-8559.