The 5 C's Report

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Join us for a crucial session led by Lee Lewis, Health Transformation Alliance Chief Strategy Officer, as we delve into the 5 C’s Report—a comprehensive assessment designed for large, self-funded employers. This report scrutinizes critical aspects of carrier performance:

Contract: Reviewing administration agreements, ensuring compliance updates, clarifying confusion, and addressing new services.

Claims Operations: Evaluating performance metrics and guarantees, ensuring alignment with provided indicators through self-reporting or independent verification.

Customer Service: Assessing key attributes in member-facing activities—Customer Service and Prior Authorization—to enhance plan value and vendor engagement.

Clinical Programs: Examining clinical programs, buy-ups, and ancillary services based on utilization, performance, and cost, with recommendations for adjustments.

Compensation: Accounting for all compensation from the previous year, including stated fees and other nuanced elements like claims-based or performance-based fees.

Don't miss this opportunity to understand and implement these critical evaluations for enhanced carrier accountability and optimized plan management.