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Relevant Healthcare's suite of products and services are all free to implement and all drive significant savings. Most products are priced at a % of Savings - we only charge when we capture savings - with one product offered as a PEPM. We can offer PEPM and PMPM models as well. We take a laser approach and focus on specific high dollar areas of the current healthcare system and have created innovative ways to reduce costs significantly for any self-funded employer, union or municipality. All products are appropriate for the employee benefit space, but a few are also applicable in Workers' Compensation. We are looking to partner with innovative and aggressive consultants, employers and TPAs who have realized that the traditional approaches simply are not working. If you are one of those groups or individuals, we want to talk to you!
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Powerful solutions for today’s healthcare marketplace
Who is Relevant Healthcare Cost Containment?
A national medical cost containment organization that focuses on price transparency and high cost areas of
healthcare for:Employee Benefits
Workers' Compensation and
Self-Pay markets
Who is Relevant Healthcare Cost Containment?
Our services benefit
Self-funded employers/Unions seeking to control healthcare costs
TPAs needing to curb payments on high-dollar procedures
Workers' Compensation insurance carriers/TPAs looking to lower costs
Self-Pay (uninsured/High Deductible) patients seeking value
Brokers/Consultants looking to go the extra mile to save clients’ dollars
Relevant offers significant cost savings solutions
Consultative and unbundled structure
All products except our Pharmacy Price Transparency Tool and Bill Audit are available to any payer for no cost
All other revenues are earned based upon the savings captured
Very little cost or risk associated with our programs
We can also perform complimentary cost savings analysis for any of our products.
Product and Service Offering – Group Health
Radiology Benefit Management (MRI, CT, CTA, MRA, PET Scans)
On average, 10% of population has imaging test per year
National network of imaging centers
All facilities NCQA certified and ACR accredited
No fees, no risk and immediate ROI
“Concierge Service” for members and treating physicians
Average savings ~30-50% below PPO rates
Product and Service Offering – Group Health (cont.)
Specialty Pharmacy Management
Focus on ‘high dollar’ Specialty Drugs
Manage cases directly to secure deeper savings via a proprietary network
Average savings is 35% or $5,200 per claim/fill
Success rate of 80%
Priced as a % of the savings achieved.
Product and Service Offering – Group Health (cont.)
Claims Settlement or Negotiation Services
UCR re-pricing/clinical review or direct provider negotiations
Focus on very high dollar claims:
Dialysis
Oncology
In-patient hospital claims
Savings ranges from 30% to as high as 90%.
Priced at a % of savings.
Product and Service Offering – Group Health (cont.)
Bill Audit-Fraud/Waste/Abuse Detection
Cloud-based system that focuses on accurate billing and coding
Contains millions of edit combinations
Clinical edits are done in real time
Implementation is free, and is as easy as downloading an “App”
Success rate average = 78%
Average savings ranges from an additional 15-30%.
Priced at % savings
Product and Service Offering – Group Health (cont.)
National Lab Network
National lab network
Claims sent to RHCC for repricing
Place Lab Company logo on ID card
Average savings ~85% off billed charges
Priced at % of savings
Product and Service Offering – Group Health (cont.)
Pharmacy Transparency ToolWeb-based tool
Educates, motivates and empowers employees to save out-of-pocket expenses on Rx
Proactively researches and delivers savings opportunities to members via:
Text message
For every $1 saved by the member, employer can save up to $6
Average savings ~22%/member; 44%/employer
Pricing on a PEPM basis
Product and Service Offering – Workers’ Compensation
Radiology Network
National Lab Network
Bill Audit Services
Age of Injury Report (additional)
Assists adjuster to mitigate or deny questionable WC claim
Independent review of original diagnostic images and report by licensed radiologist
Helps determine if injury is chronic or related to work accident
Flat fee of $275
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