Third Party Administration Services

THE INNOVATIVE HEALTH CARE DELIVERY SOLUTION

Preferred Care, Inc. ("PCI"), initially through a predecessor affiliate, has provided TPA services to clients since 1974.  The TPA has evolved from a claims paying organization into a full service organization which provides a full spectrum of insurance administrative services, including claims administration, billing, generation of plan documents, full utilization management and the inclusion of provider networks into the plan design.

PCI is currently authorized to provide TPA services in over 48 jurisdictions throughout the United States.

Our client base includes fully insured and self-funded employer groups, Consumer Driven Health Plans (CDHP), associations, and special markets such as a student program, global programs, college sports, voluntary medical and other special risk coverage’s.

The key principles upon which PCI's TPA operation was founded still exist today.  These principles are strong customer service, customization of benefits, utilization management and being a full service TPA.

PCI prides itself in providing outstanding customer service.  Our claim objective is to process 98% of all claims in ten (10) days and to maintain quality standards of payment well above the industry standards.

Our claim and billing systems are flexible and allow us to customize any type of benefit program.  In addition to medical benefits, life, AD&D, disability, dental, vision and prescription coverage’s can be incorporated into the plan.  PCI can also accommodate fully insured, self-funded, and partially self-funded programs.

One big advantage that PCI has over other TPAs is our extensive provider network and comprehensive medical review program.  PCI works as your partner, managing your healthcare dollars.  Our Utilization Management Program is a comprehensive medical service program including prospective review, concurrent review, discharge planning and case management.  Our PPO network provides ready access to more than 10,000 facilities and more than 300,000 providers nationwide.  Comprehensive management reports are provided to you to help you identify utilization trends and make decisions on your benefit plan.

Flexible Spending Account (FSA), Health Reimbursement Account (HRA), Health Savings Account  (HSA), and Mass Transportation and Parking programs are provided as an exciting addition to your current benefits plan. CDHP’s are quickly replacing traditional benefits plans as they aid employers in meeting their employee’s health care needs as well as being afforded tax benefits for the employer and employee.  PCI follows all IRS regulatory guidelines, expertly administering your plan while maintaining your qualified status.  PCI also offers a pre-paid card option which may be added to these products.

PCI, in addition to providing claims administration services, also assists  you with premium accounting, enrollment activities, and generation of plan documents, availability of COBRA support, HIPAA compliance, and employee communications.

In summary, PCI and affiliates have been providing effective TPA administration services for over 20 years.  We have maintained an excellent regional and nationalreputation by providing consistent, cost effective and professional services to our clients.  We hope you will decide to join PCI's growing family of satisfied customers.