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Aplos overview
Agenda
Introduction Agenda
Aplos Introduction
Introduction Unified Experience
Fairos Overview
Company Overview The Fairos Advantage Why Choose Fairos? Fairos Results
Pre-Auth Process
Re-Thinking Pre-Auth New Pre-Auth Message
Engagement & Enrollment
Engagement & Enrollment Personalized Virtual OE Post-Enrollment Education Implementation Coordinator Credentialed Benefit Counselor Thank you
No slides found. :(
Aplos overview

Agenda

 

 

  • APLOS INTRODUCTION

 

  • FAIROS OVERVIEW

 

  • PRE-AUTH PROCESS

 

  • ENGAGEMENT & ENROLLMENT

 

  • NEXT STEPS
Agenda
Introduction Agenda
Aplos Introduction
Introduction Unified Experience
Fairos Overview
Company Overview The Fairos Advantage Why Choose Fairos? Fairos Results
Pre-Auth Process
Re-Thinking Pre-Auth New Pre-Auth Message
Engagement & Enrollment
Engagement & Enrollment Personalized Virtual OE Post-Enrollment Education Implementation Coordinator Credentialed Benefit Counselor Thank you
No slides found. :(
Aplos overview
introduction

 

THE PROBLEM

  • Legacy PPO Health plans have failed to control costs
  • Unbundled Self-Funded Health plans have had a difficult time creating a better user experience than traditional fully insured plans.

 

THE SOLUTION

  • Finding TPA’s, Technology, PBM’s, Stop loss Carriers, Medical Management, & Network providers who will truly work as partners, share data & work as a team.
  • Education & engagement with members throughout the year as to how their plan works & how the technology at their fingertips can help save them money.

 

DRIVING ACTIVE COST CONTAINMENT

  • Pre-integrated components.
  • Easier to scale and service groups.
  • Greater efficiencies which we pass along to the client.
  • Aplos technology allows for greater plan design flexibility & member steerage.
  • Member engagement and education year-round.
unified experience

 

THE PROBLEM

  • Legacy PPO Health plans have failed to control costs
  • Unbundled Self-Funded Health plans have had a difficult time creating a better user experience than traditional fully insured plans.

 

THE SOLUTION

  • Finding TPA’s, Technology, PBM’s, Stop loss Carriers, Medical Management, & Network providers who will truly work as partners, share data & work as a team.
  • Education & engagement with members throughout the year as to how their plan works & how the technology at their fingertips can help save them money.

 

DRIVING ACTIVE COST CONTAINMENT

  • Pre-integrated components.
  • Easier to scale and service groups.
  • Greater efficiencies which we pass along to the client.
  • Aplos technology allows for greater plan design flexibility & member steerage.
  • Member engagement and education year-round.
Agenda
Introduction Agenda
Aplos Introduction
Introduction Unified Experience
Fairos Overview
Company Overview The Fairos Advantage Why Choose Fairos? Fairos Results
Pre-Auth Process
Re-Thinking Pre-Auth New Pre-Auth Message
Engagement & Enrollment
Engagement & Enrollment Personalized Virtual OE Post-Enrollment Education Implementation Coordinator Credentialed Benefit Counselor Thank you
No slides found. :(
Aplos overview

contracting team

 

BEST-IN-CLASS MEDICAL BILL NEGOTIATION

 

SELECTION

  • Proprietary aptitude assessment test
  • Identifies personality band & specific skills

 

TRAINING

  • 4-6 months to Level-1 negotiations
  • Data-supported negotiation techniques 
  • 20 years of negotiation expertise 

 

COMPENSATION

  • Quality (discount achieved)
  • Turn Around Time (speed of settlement)
  • Scale (conversion to long-term agreement)

Measurements occur on each negotiation

Why Fairos?

 

FAIR AND OPEN PRICING

 

PPO Discount's are illusionary. 

We believe providers should be paid fairly... 

 

PPO Reimbursement Range:

  • 225 to 350% of Medicare

 

RBP Reimbursement Range:

  • 120 to 170% of Medicare

 

Fairos Avg. Effective Medicare Rate:

  • 142% of Medicare

fairos Results

SUPPORTING MEMBERS. SAVING MONEY.

 

Our personal member advocates and professional team of medical bill negotiators consistently deliver our clients with industry-leading results.

Agenda
Introduction Agenda
Aplos Introduction
Introduction Unified Experience
Fairos Overview
Company Overview The Fairos Advantage Why Choose Fairos? Fairos Results
Pre-Auth Process
Re-Thinking Pre-Auth New Pre-Auth Message
Engagement & Enrollment
Engagement & Enrollment Personalized Virtual OE Post-Enrollment Education Implementation Coordinator Credentialed Benefit Counselor Thank you
No slides found. :(
Aplos overview
aplos = seamless coordination

 

THE PROBLEM

  • Legacy PPO Health plans have failed to control costs
  • Unbundled Self-Funded Health plans have had a difficult time creating a better user experience than traditional fully insured plans.

 

THE SOLUTION

  • Finding TPA’s, Technology, PBM’s, Stop loss Carriers, Medical Management, & Network providers who will truly work as partners, share data & work as a team.
  • Education & engagement with members throughout the year as to how their plan works & how the technology at their fingertips can help save them money.

 

DRIVING ACTIVE COST CONTAINMENT

  • Pre-integrated components.
  • Easier to scale and service groups.
  • Greater efficiencies which we pass along to the client.
  • Aplos technology allows for greater plan design flexibility & member steerage.
  • Member engagement and education year-round.
new Pre-auth messaging

 

THE PROBLEM

  • Legacy PPO Health plans have failed to control costs
  • Unbundled Self-Funded Health plans have had a difficult time creating a better user experience than traditional fully insured plans.

 

THE SOLUTION

  • Finding TPA’s, Technology, PBM’s, Stop loss Carriers, Medical Management, & Network providers who will truly work as partners, share data & work as a team.
  • Education & engagement with members throughout the year as to how their plan works & how the technology at their fingertips can help save them money.

 

DRIVING ACTIVE COST CONTAINMENT

  • Pre-integrated components.
  • Easier to scale and service groups.
  • Greater efficiencies which we pass along to the client.
  • Aplos technology allows for greater plan design flexibility & member steerage.
  • Member engagement and education year-round.
Agenda
Introduction Agenda
Aplos Introduction
Introduction Unified Experience
Fairos Overview
Company Overview The Fairos Advantage Why Choose Fairos? Fairos Results
Pre-Auth Process
Re-Thinking Pre-Auth New Pre-Auth Message
Engagement & Enrollment
Engagement & Enrollment Personalized Virtual OE Post-Enrollment Education Implementation Coordinator Credentialed Benefit Counselor Thank you
No slides found. :(
Aplos overview
engagement and enrollment

 

PROJECT MANAGEMENT MEETS STRATEGY

 

  • Dedicated Implementation Manager to manage all aspects of project
  • Support for Case Setup & Implementation Timeline
  • Project Management support of build on new or current HRIS platform for new benefits and benefit changes, if applicable
  • Test plan & Testing
  • Benefit Counselor Credentialing & Case Training
  • Custom Communication Plan
  • Enrollment & Case Management
  • Data Management & File scrub
  • Post Enrollment

 

 

PAIRING PEOPLE WITH PLATFORM

 

New App, Ep6enroll.app, powered by Enrollify;

  • Ringless Voicemail; Direct communication from HR
  • Text communications including links
  • Communication portal for document storage
  • Schedule virtual meeting w/ a Benefit Counselor

Enrollment Options

  • Call Center
  • Virtual Screen share meeting

Credentialed Benefit Counselors

  • Employee feedback after each consult(Uber style)
  • HR Reporting: Enrollment Completion & App Status

 

ENROLLMENT TECHNOLOGY & BENEFIT ADMINISTRATION

 

  • Build Business structure & Case
    • Establish Payroll Integration
    • Carrier Feeds(Initial & Ongoing)
  • Broker & Client Reporting Access
  • Summary Billing(with Aflac Group Products)
  • Third Party Administration Support
    • Cobra Administration
    • CDHP Administration(FSA, HRA, HSA, Transit)
  • Dedicated Client Support
  • IF CLIENT HAS A CURRENT HRIS/BEN ADMIN SOLUTION WE WILL SETUP BENEFIT COUNSELOR TO WORK WITHIN CURRENT ENVIRONMENT
post-enrollment education

 

THE PROBLEM

  • Legacy PPO Health plans have failed to control costs
  • Unbundled Self-Funded Health plans have had a difficult time creating a better user experience than traditional fully insured plans.

 

THE SOLUTION

  • Finding TPA’s, Technology, PBM’s, Stop loss Carriers, Medical Management, & Network providers who will truly work as partners, share data & work as a team.
  • Education & engagement with members throughout the year as to how their plan works & how the technology at their fingertips can help save them money.

 

DRIVING ACTIVE COST CONTAINMENT

  • Pre-integrated components.
  • Easier to scale and service groups.
  • Greater efficiencies which we pass along to the client.
  • Aplos technology allows for greater plan design flexibility & member steerage.
  • Member engagement and education year-round.
implementation coordinator


Drives a uniform process, manages timelines, trains Benefit Counselors and supports all stakeholders though
reporting and problem solving that leads to dependable and expected results.

 

THE PROBLEM

  • Legacy PPO Health plans have failed to control costs
  • Unbundled Self-Funded Health plans have had a difficult time creating a better user experience than traditional fully insured plans.

 

THE SOLUTION

  • Finding TPA’s, Technology, PBM’s, Stop loss Carriers, Medical Management, & Network providers who will truly work as partners, share data & work as a team.
  • Education & engagement with members throughout the year as to how their plan works & how the technology at their fingertips can help save them money.

 

DRIVING ACTIVE COST CONTAINMENT

  • Pre-integrated components.
  • Easier to scale and service groups.
  • Greater efficiencies which we pass along to the client.
  • Aplos technology allows for greater plan design flexibility & member steerage.
  • Member engagement and education year-round.
credentialed benefit counselor

 

 

THE PROBLEM

  • Legacy PPO Health plans have failed to control costs
  • Unbundled Self-Funded Health plans have had a difficult time creating a better user experience than traditional fully insured plans.

 

THE SOLUTION

  • Finding TPA’s, Technology, PBM’s, Stop loss Carriers, Medical Management, & Network providers who will truly work as partners, share data & work as a team.
  • Education & engagement with members throughout the year as to how their plan works & how the technology at their fingertips can help save them money.

 

DRIVING ACTIVE COST CONTAINMENT

  • Pre-integrated components.
  • Easier to scale and service groups.
  • Greater efficiencies which we pass along to the client.
  • Aplos technology allows for greater plan design flexibility & member steerage.
  • Member engagement and education year-round.

thank you

PRESENTED BY

 

 

  

William Coleman

CEO 

Email: bcoleman@ushealthone.com

Phone: (214) 347-0700

Agenda
Introduction Agenda
Aplos Introduction
Introduction Unified Experience
Fairos Overview
Company Overview The Fairos Advantage Why Choose Fairos? Fairos Results
Pre-Auth Process
Re-Thinking Pre-Auth New Pre-Auth Message
Engagement & Enrollment
Engagement & Enrollment Personalized Virtual OE Post-Enrollment Education Implementation Coordinator Credentialed Benefit Counselor Thank you
No slides found. :(