MAM for Plan Administrators

As a Third Party Plan Administrator or Insurance Carrier, you may feel that MAM’s Advocacy Services pose a threat to your own internal customer services and are not necessary. However, you need to think again.

The fact is that the majority of Americans view the Insurance Carrier or TPA as “The Bad Guy.” Too often they feel they are being cheated out of services they are entitled to, and that the person at the other end of the phone is doing everything in their power to prevent a positive outcome. Errors with claims and billings are routinely blamed on you when the real culprit is the mishandling of information at the provider level.

Acting as an independent advocate, MAM works successfully with TPAs and Carriers to assist your members in navigating the healthcare maze. This facilitates and expedites the claims paying process which translates into less administrative costs for you, and decreased liability with regards to ERISA. When problems occur, MAM obtains the necessary information for proper claims adjudication from the required party, and gets it to you in a timely manner. Additionally, MAM educates and directs clients on the most appropriate way to use their benefits. This cuts down on confusion and mistakes with regards to in and out-of-network benefits, and non-covered services that can lead to frustration with your product.

Benefits to You:

• Additional value added services for your member/group clients
• Increased client satisfaction and participation in the plans you offer
• Reduced paperwork and administrative headaches
• Reduced liability due to ERISA compliance issues
• Smoother implementation of the plans
• Professional expertise to match your own

Benefits to Your Client:

• Improved employee satisfaction and participation with health plan offerings
• Reduced liability due to HIPAA and ERSIA compliance issues
• Increased employee productivity and morale
• More time and efficiency for client’s HR staff