Our Critical Case Management team is dedicated to timely authorizations, claims, and appeal resolutions for you, your employees, and their family members. Our specialists apply critical expertise to provide the best support possible when your employees and their families are in need.
Critical Case Management
From time to time, you and your employees are faced with serious medical conditions. This can be a frightening and challenging situation. Our team is capable of delivering the knowledge and experience needed to navigate through these difficult times. From referrals to appeals, we are with your employees every step of the way.
Claims Analysis & Arbitration
As the cost of healthcare continues to rise, erroneous or inaccurate claim processing can result in significant sums of money being incorrectly billed to your employees. This can affect the bottom line for both the employer and the employee, causing stress and confusion. Our team is here to guide and support you and your employees through these complex and challenging situations.
We offer personalized support with:
The temporary Medicare Part D premium stabilization subsidies are ending after 2026. As a result, some Medicare beneficiaries may see changes to their standalone Prescription Drug Plan (PDP) premiums and coverage options in 2027.
For many people, Medicare can feel mysterious or confusing as they approach age 65. The program is structured differently from the employer-sponsored health plans most people are accustomed to, including its approach to preventive care.
Overview of ACA affordability requirements for employer-sponsored health coverage, including annual percentage thresholds, IRS safe harbors (FPL, Rate of Pay, Form W-2), and key factors affecting employee contributions such as flex credits, opt-out incentives, and wellness programs.
As more Americans work longer and delay retirement, international travel is increasingly part of the conversation for employees over age 65. Whether it’s a bucket‑list trip before retirement or extended travel after scaling back work, there’s one critical issue many overlook: health coverage outside the U.S.
The IRS released the 2027 health savings account (HSA) annual contribution limits and high deductible health plan (HDHP) requirements in IRS Rev. Proc. 2026-24.
Each year, employers may be responsible for reporting and paying the Patient-Centered Outcomes Research Institute (PCORI) fee. Here’s a high-level overview of what to expect for the 2026 filing cycle.
Stay informed about Medicare Part D changes in 2026. Learn how to avoid coverage gaps, rising drug costs, and enrollment mistakes with simple tips for reviewing and managing your Medicare prescription drug plan.
Confused by biologics and biosimilars? Learn what these are and what you should know when reviewing your insurance plan's prescription coverage.
Wondering how telemedicine is covered by insurance? Learn what to expect from virtual visits, costs, and claims processing.
What "covered" should feel like.
What "covered" should feel like.
What "covered" should feel like.
What "covered" should feel like.
What "covered" should feel like.
