THIRD PARTY ADMINISTRATION | SPECIAL MEDICAL REIMBURSEMENT
Containing Costs while Maintaining Benefits
The cost of health care continues to rise for employers and their employees, but there is an answer: EHIM. And we have been successfully servicing clients as a
Third Party Administrator for over 20 years.
Besides our PBM product, we have a unique and innovative way to save on your medical program. We call it our Special Medical Reimbursement Program (SMRP).
Our SMRP program is an effective solution for any organization trying to contain their healthcare expenditures while maintaining their employee benefit levels. How? The group purchases a high deductible plan then through the SMRP, EHIM will reimburse employees/ pay providers for healthcare expenses (such as deductibles, co-insurance, office visit and emergency room copays) in order to maintain the same level of coverage they enjoyed before.
Here’s an example:
Last year your employee paid $10 for an office visit and had no deductible, but due to rising expenses, their employer-sponsored plan for the new year requires an out-pocket copay of $30 for an office visit and has a $1000 deductible. You as the employer want your employee's benefit to be the same.
The answer: Through the SMRP program, EHIM will now reimburse the employee $20 for the same visit, thereby “mirroring” the $10 copay from the previous plan. All claims that go towards the deductible are processed and paid to the provider by EHIM. The employee has the same benefits and this saves the employer money, as they have purchased a less expensive plan but mirror previous benefits by agreeing to reimburse certain expenses as they occur.
EHIM is an organization that understands the intricacies of medical claims processing including in-network and out-of-network benefits, participating and non-participating providers, copayments, deductibles and coinsurance. Our commitment to creative concepts, cost containment, and customer care are clearly demonstrated with our efficiency in claims processing, flexible technology, detailed reporting, and hands-on customer service. Our SMRP program enables employer groups to achieve maximum cost savings with minimal administrative effort.
Whether you are a smaller, privately held corporation, a large publicly owned organization, or a government entity, EHIM can offer a customized solution that enables employee benefit levels to be maintained while healthcare expenditures are reduced.
For more information on how our SMRP program can supplement current coverage, please contact us at 800-311-3446.