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12 Provider Networks
The IDA Difference
Tired of endless annual premium increases, never knowing what was actually spent? Not with self funding. Pay only for charges as they are incurred. All administration costs are set in advance. Transparency and accountability through plan performance reports - because it is your data after all.
Let IDA help you take control back!
We serve both private and government employers, unions, consortiums, HIFs, brokers, providers and patients. Independently owned, we provide what you actually need, not pre-planned or canned products. Whatever aspect, from consulting to full administration or just a portion thereof, we never forget who the client is - YOU.
Medical, Vision, Dental, COBRA, HSA, HRA, FSA, Commuter and NJSHBP Differential benefits. HIPAA X12 835/37 enabled and compliant. It is what we do
– since 1983.
With prescription inflation outpacing all other plan costs, selection of your PBM has never been more important. IDA provides national PBM access with acquisition costs that often beats consortium pricing. 100% of rebates go to our clients. Carve out specialty arrangements when needed.
Provider Network Access
Evaluation and placement of the best network for your plan. National, regional, local and Reference Based Pricing solutions. Disruption and discounting studies benchmarked to your current arrangement.
Extensive review of medical necessity, coding and billing. Repricing and negotiation of remaining charges on a R&C, FAIR Health, RBP or percentage of Medicare basis.
The essential umbrella coverage of your plan. We market extensively to multiple national markets to get the best terms, premium and attachment point for your plan.
Whether placed by IDA or not, we can coordinate filings with the reinsurer (triggers, large case notification, 50% reports, advance funding and reimbursement requests).
Plan Design & Building
We can mirror ANY plan design. We consult on recommended changes and impact to the bottom line. Once finalized, we build the logic into the automatic edits of our claims system to produce the exact outcome you designed.
To make our Clients’ lives simpler. IDA provides consolidated billing, centralizing and itemizing all composite costs, and then facilitates vendor remittances.
Funding & Payment Fulfillment
At IDA, your claims account is your account and your money. Claims funding is on your selected schedule where funding requests equal distributions for a zero balance account. No reserves or withholds. Traditional check and ACH/EFT payment options.
Measurement of plan performance is essential. Professional series reports for actuarial and underwriting purposes are generated through our claims system, LuminX. Summary reporting for employers and brokers are enabled through our alliance with PlanWatch.
You can always reach a person at IDA. Our Customer Service is personal, professional and located on-site in Oakland. No outsourcing. All benefit designs and claims information is available to the representative. Our aim is to provide one call resolution.
IDA maintains multiple professional memberships to position your plan for upcoming challenges. IDA supports all annual reporting requirements, including SBCs, SPDs, SMMs, HIPAA, CHIPRA, 5500 and the 1094/1095 filing series.
IDA works with you to design the level of involvement you wish to retain, often serving as an adjunct to your staff in initial enrollment, adds, drops and coordination of NJFMLA, FMLA, disability and leave policies as it applies to plan enrollment. HIPAA X12 834 capable and compliant.
Chamber of Commerce
IDA will coordinate all of the plan & carrier offerings, rates and consolidated billing for your Chamber of Commerce. We will also handle enrollment and customer service. We are as integrated or separate as a Chamber directs. A true partnership.
A IDA provides back room adjudication services for other TPAs and carriers. In addition, when no conflict exists in doing so, IDA conducts audits on behalf of health plans and their advisers on a regional and national basis.