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S&S Services
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Claims Administration
Our state-of-the-art claims payment system can accommodate even the most diverse benefit plans. Services include:
- Medical Claims
- Dental Claims
- Vision Claims
- Prescription Drug Programs
- Disability Administration
- COBRA/HIPAA Administration
- Flexible Spending Accounts
- Surcharge Administration
Benefit Plan Design
S&S will periodically review a clients plan design in order to achieve desired cost savings, maintain compliance with federal legislation and increase the auto adjudication level.
Customer Service
Our customer service personnel are trained claims professionals who stand ready to assist employees with questions about covered services, benefit plan payments, etc.
Member Communication and Inservicing
The account management staff at S&S will assist employers in the creation of member communications and are available for on-site HR or employee meetings.
Managed Care and PPO Arrangements
Relationships with a number of local, regional and national preferred provider organizations (PPOs) can offer additional savings for plan sponsors.
Utilization Review Services
Our UM department has designed a program that maintains the highest possible quality of care while holding the related costs to a minimum. Services include:
- Preadmission Certification
- Concurrent Review
- Retrospective Review
- Large Case Management
- Discharge Planning
- Psychiatric and Substance Abuse Review
- Referrals to Specialists
Stop Loss Protection
A variety of carriers, all of who have achieved an "A" rating or better, provide the best excess loss coverage available. Services include:
- Initial Marketing and Coverage Placement
- 50% Notifications
- Aggregate Reporting
- Claims Filing
- Renewal Marketing
Reporting and Data Analysis
Standard and client specific reports can be provided on a monthly, quarterly or annual basis. Through the wide range of data maintained in the claims system, we can report on demographic, financial and utilization information that is beneficial in determining the cost effectiveness of any program.
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