Self-funded health plans can achieve significant savings by adding ELAP’s metric-based pricing solution. ELAP’s metric-based pricing solution goes beyond a reference-based pricing model by considering both Medicare reimbursement and the actual cost to deliver the service; and adds a fair profit margin.
ELAP offers flexible solutions so that employers can tailor a plan to fit their needs. The foundation of each solution is our claim review and audit program.
Metric-Based Pricing (MBP)
Facility & Professional*
Negotiation – Post Service
Strategically placed negotiations within
balance bill process to reduce disruption
Expert Legal Support
*Includes physician and specialist services.
Using our extensive data, market analysis and your current health plan design, ELAP will create a customized savings analysis.
CUSTOM PLAN DESIGN
ELAP works with your health plan to define claim reimbursement limits that work for you.
ELAP BECOMES A CO-FIDUCIARY
ELAP stands shoulder-to-shoulder with you as a co-fiduciary and
proactively advocates for the best interest of the plan.
CLAIM REVIEW & AUDIT
ELAP reviews every provider claim for errors or
unexplained charges, and uses our comprehensive metric-based pricing
model to define a fair and prompt payment to the medical provider.
ONGOING SUPPORT & ADVOCACY
ELAP offers the strongest personal member advocacy available. Our large
dedicated service team and online resources streamline the member experience.