Why Choose Insight?
We’re glad you want to know.
Insight Benefit Administrators is a Michigan TPA located in Grand Rapids, Michigan. We serve employers in Michigan and Ohio, and can cover members who are located anywhere in the U.S.
Through experienced operations, innovations in claims management, flexible and creative plan designs and best-in-class vendor partners, Insight brings a unique value proposition to our clients and our membership.
Insight continually looks to engage plan design solutions that are easy for members to navigate and translate into immediate savings for our clients.
We’re set up to give you the attention you deserve.
- Our President and executive staff are involved in every new client implementation and we meet with our clients regularly
- Our size allows us more agility and quicker response time
- Our average claim turnaround is just 3 to 5 business days
- We ensure transparency in all claim data and pricing
We perform extensive claim scrubbing for every bill type.
- We employ a Network Navigator (Over 60 networks)
- We audit all claims and bills for all claim types
- We offer flexibility in Coordination of Benefit rules
- We continually audit dependent eligibility
- We are more restrictive with auto adjudication parameters
- We regularly monitor for Third Party Liability
Our benefit design strategies are focused on cost containment. Our approach includes:
- Living Connected Diabetes Management program
- “Right Tier” Copay structure for pharmacy benefit management
- Specialty Pharmacy Carve-Out alternatives
- Dialysis negotiations for additional discounts
- Promoting free-standing high-tech radiology procedure alternatives
- Promoting free-standing surgical procedure alternatives
We employ Integrated Claim and Case ManagementTM (ICCM) for:
- Redirecting initial or subsequent care
- Identifying new potential high dollar claims through data sharing
- Managing high dollars with targeted Case management*
- Performing Medical Necessity Reviews*
- Negotiating conditional lasers
- Benchmarking Stop Loss review of certain high cost claimant claim profiles
* All Pre-Certification, Case Management and Medical Necessity Review is performed by Triple URAC Accredited Case/Care management provider.
We make it easy for you.
- Insight clients each have a personalized, private web portal
- Members can enroll online and always find benefit and claims information too
- You can make changes and additions to your census online
- We’ve chosen the technology that’s best in class for speed, accuracy and quality outcomes
Let us show you the benefits of working with Insight.