Globalcare Simply More

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GlobalCare’s core business is to maximize the savings on each and every medical claim.  We exist for the singular purpose of returning the greatest discounts on every claim with the lowest transaction cost. 

PAYER:   Greater Access & Savings with Lower Costs

NETWORK OPTIMIZATION

• Access to over 150 PPO networks
• Deeper discounts for greater savings on both  primary & secondary network claims
• Configurable network solution at granular level
• Eliminate reversals; Dispute rate of 0.42%

WORKFLOW MANAGEMENT

• Single interface to 200 Trading Partners
• Custom solutions designed to Your systems and work flow processes
  

TRANSPARENCY

• Web-based tracking & reporting systems on all file and claim activity

PROVIDERS:  More Patients; Accurate and Timely Payment

• New patients acquisition from both near and far away
• Full compliance to all  provider agreement for patient access and discounts
• Quality pricing of claims delivered to payer electronically to ensure means to prompt payment

PATIENTS:  More Choice, More Care

• Greater provider selection for both primary and secondary network
• Over 650,000 providers directly accessible including Centers of Excellence
• A Medical Nurse Help Desk to assist with any medical situation
• Lower out-of-pocket expense by access to the most appropriate level of care

NETWORK OPTIMIZATION

Our model is built upon steering members into the most appropriate level of care at the time of any medical event.  It starts with configuring unique medical network solutions for each member at the Primary level to provide broad access to providers along with deep discounts.   Equally, GlobalCare configures a Secondary network hierarchy per member to maximize total dollar savings on all claims.  In addition to network optimization, we offer members eMDnet™ as a web-based referral service and our Medical Nurse Help Desk when the member is traveling outside of their primary area. The objective is to obtain the greatest financial return through deployment of proactive, interventionist measures to ensure members gain access to the most appropriate provider and level of care at any given time or place. 

WORKFLOW MANAGEMENT WITH TOTAL TRANSPARENCY

We are acutely aware of the value and meaning of savings to our clients, and more so on how to consistently derive favorable results.   Our approach is to quantitatively analyze complex situations where membership is dispersed by geography, demographics, and products and then assign each member to a best-in-class network.  We achieve greater efficiency both operationally and financially through utilization of proprietary technology to match and route all claims to and from the selected network for re-pricing.  Managing the integration to our client’s preferred processes and systems is a core competency of GlobalCare, and one that creates added-value by providing access to over 200 trading partners.  Our transaction-based approach in which we electronically transport claims between our clients and trading partners delivers operational efficacy, accuracy and permits transparency between all.  It validates the durability of our model by its value to lower costs and maintain savings integrity when each network re-prices their own provider claims.  

GlobalCare  Simply More