A Different Approach to Cost Containment

Comprehensive. Unique. Benchmarked.

Over the past 20 years, we’ve developed an approach to handling medical claims that differs completely from our competition. We call it a “blended approach”, and it combines negotiated settlements, PPO networks, and direct contracts.

The result? Exceptional savings benchmarked against independent numbers.

This practice, in the hands of our seasoned negotiators, enables us to consistently outperform industry standards and achieve superior results. The advantage to our clients is clear: solid performance measurement.

True cost containment is NOT just about getting ANY discount – it’s about getting the RIGHT discount.

We benchmark against Medicare rates as well as up to 12 other industry standards. Without these measurements – on each bill – how would we know whether the discount being generated is good or bad?

Global Excel sees the cost containment process in a much wider scope than our competitors.

We start with policy wording (many clients take advantage of our expertise in this area). It involves proactive medical case management. It means directing your members to the right healthcare provider and having the right networks in place.

In addition to all of this, bill editing and adjudication are absolutely essential to cost containment if you want to be sure you’re only paying for services actually delivered, and which are covered by your policy.

Other things to factor in? Knowing whether your discount is a good one, and the possibility of recovering sizeable amounts in Third Party Liability (3PL) cases. We make sure nothing’s left to chance.

Tying everything together? Industry-leading analytics with actionable insights. If you can’t measure it, you can’t prove it.

At Global Excel, we access over 150 regional and national PPO networks.

We can provide access to selected HMOs. With a consistent volume of over $740M in billed charges, we are also large enough to have providers under direct contract all over the U.S.

Negotiation is not easy and because of that many of our competitors shy away from offering negotiated settlements.

We don’t. In fact, we consider this to be our area of expertise. Our negotiation strategy is specifically designed to provide you with exceptional savings. This practice, when carried out by our experienced negotiators, allows us to outperform the industry and achieve superior results.

The outcome for successful negotiations is this: signed settlements for all negotiated deals that provide locked-in results with no “noise” to manage for our clients.

Longer length-of-stay (LOS) cases (3 days or more) can materially affect the financial performance of a book of business.

At Global Excel, we have developed a unique approach to managing these cases. This solution, known as GEM Clinical™, is offered in two versions tailored to meet specific client needs and requirements.

For more details, contact us.

A part of cost containment that is often overlooked (but is absolutely essential) is bill editing.

At Global Excel, we make use of powerful software that is designed to identify billing errors. This unique tool has helped us to identify opportunities for significant savings on inpatient, physician and outpatient bills. It all adds up and helps to generate greater savings for our clients.

Global Excel was amongst the very first cost containment specialists to see recovery services as a tactical aspect of reducing costs for ourselves and then for our clients.

We employ a team of dedicated lawyers, assisted by paralegals, who all specialize in the recovery of funds. When it comes to Third Party Liability (3PL) cases, our legal team is supplemented by an extensive and expert legal network throughout North America.

Global Excel’s customized networks offer our clients outstanding reach at competitive prices.

The way in which we develop our networks provides the depth and breadth that our clients can count on, no matter where their members are visiting in the U.S.

  • We develop exclusive networks based on client demographics and utilization
  • We have access to over 150 local and regional PPO networks in all 50 states, as well as access to the large HMOs
  • We are also able to offer pharmacy, dental and vision networks in all 50 states
  • We have access to specialized cancer and transplant networks

Our network managers continually evaluate network utilization and use the data collected to help optimize our network coverage. These individuals focus on identifying savings opportunities to continuously enhance our overall performance.

Ready
when you are