What’s the Fix?
PforP Health, a New Jersey-based company, provides self-insured health plans with unique and cost-saving insights into their medical, pharmaceutical, and administrative expenditures. Pforp Health utilizes automated IT and artificial intelligence to analyze financial transactions and clinical decision-making, coordinating these data with plan design, benefits, and best practices. Through strict auditing and oversight of the claim adjudication process, health plans accrue significant savings as fewer healthcare dollars are lost to ineligible or inappropriate claims, duplicate payments, overpayments, or hidden administrative charges.
By identifying utilization trends and implementing proven coordinated care programs, PforP Health bends the cost curve to a more sustainable trajectory. It is powered to intervene at the provider, patient, and network level. PforP Health can identify needed areas of improved provider care and can facilitate direct contracting between self-funded plans and providers to improve quality, transparency and cost containment.
PforP Health will identify needed areas of improved provider care and will facilitate direct contracting between a self-funded plan and providers to improve quality of care and transparency.
Through oversight of the claim adjudication process, less of the plan’s funding will be lost to unnecessary payment of claims, duplicate payment, or overpayment which traditionally is difficult to recoup.
PforP Health guards against the self-funded plan paying for personal injury and Workers’ Compensation cases which should be covered by a separate insurance plan.
PforP Health integrates healthcare data analytics with action.
Get in Touch
PforP Health recognizes the challenge to self-funded plans of implementing a data warehousing, analysis, and auditing program. We offer free consultations to walk you through your needs, the scope of your goals, and your budget.