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| VALU NET |
Our Utilization
Review software tracks the PPO status of providers. We attempt network steerage whenever
it would not affect the quality of the care provided to our patients. Our case management
department attempts direct negotiations with providers whenever it is possible and makes
referrals to one of our repricing entities when it is not. The
tremendous rise in healthcare costs has significantly impacted the insurance, self-funded
and HMO industries. Lack of, or ineffective PPO discounts, gaps in provider coverage and
plan members who do not willingly accept limits placed on their choice of healthcare
providers and treatments all result in increased costs that are passed on as rate
increases.
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