The majority of plan administration platforms were built prior to the implementation of the Affordable Care Act (ACA). Foundationally these systems were built around the traditional structure of benefit plan offerings, reporting and cost savings approaches. Continental Benefits was built in a post-ACA world and utilizes the Javelina system by Eldorado (an HP company) the most advanced plan administration system on the market.
The post ACA marketplace provides significant challenges for employers to maintain affordability in their benefit coverages. The removal of benefit and lifetime limits leaves plans exposed to significant potential cost. Utilizing advanced technology, Continental Benefits protects its plan sponsors by:
• Utilizing claims edits to eliminate erroneous billings
• Identifying and eliminating fraud and abuse
• Reviewing clinical appropriateness and medical necessity
• Identifying, engaging and adjusting for unreasonable billing
• Engaging providers in data sharing to enhance patient outcomes
• Building customized programs to meet changing needs
• Using Big Data to identify trends and implement compliant cost savings approaches
Not limited by the traditional technological constraints, Continental Benefits is engaging innovative partners and thought leaders throughout the country to continually enhance not only our cost savings capabilities, but the entire healthcare experience.