Our foundation is built on servicing our clients. This is accomplished by providing exceptional and personalized service to each of our clients.
24-Hour On-Call Nurse Assistance
FHA-TPA understands communication is vital and so we have made strategic partnerships with vendors offering 24-hour / 365-day access to toll-free telephonic nurse assistance. The following information will be obtained at the time of the initial call:
- Name of Claimant
- Marital Status
- Brief history / description of illness or type of service needed
- Any significant psychosocial information
- Diagnosis or symptoms of condition
- Present condition / status
- Stability of vital signs
- Prognosis (if established)
- Significant medical history and any existing/potential complications
Oncology Case Management Solutions
On average payors have a 1% incidence rate for cancer diagnosis among enrollees, however, cancer costs make up about 15% of a payor’s overall healthcare expenditures.
FHA-TPA has partnered with Biologics, Inc. to offer our clients a world-class cancer management program as an optional service to assist in deferring these costs. The “Oncology Management Solution (OMS) Program” provides our clients with a comprehensive oncology-specific strategy for patient, medication, provider and claims management that results in:
- Intense clinical support to help members have a safe and successful therapy cycle, improving patient outcomes.
- Side effect mitigation through early intervention that could otherwise result in costly emergency and inpatient care.
- Cost avoidance for unnecessary and inappropriate chemotherapy treatment through proactive medication management.
A certified Oncology Nurse Care Coordinator (OCC) and Pharmacist are assigned as the key resource to both the member and treating physician during the course of treatment.
They are responsible for guiding members through the entire treatment process.
Clinical Oncology Pharmacists are available to members 24/7/365 to maximize compliancy and clinical outcomes.
Coordination of Medical Care
Other advantages to FHA-TPA scheduling appointments include
- Earlier appointment times
- Arranging direct payment for the medical services rendered
Medical providers do not bill the insured when the appointments are scheduled through FHA-TPA and providers do not balance bill the patient for network contractual savings as the PPO affiliation is identified prior to treatment.
Many times, FHA-TPA can coordinate a global case rate for the facility or dictate which facility is utilized resulting in maximum savings for the insured and the Insurance plan.
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We remain committed to the satisfaction and success of our clients and brokers by helping you achieve the best possible health and financial outcomes.