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RCI introduces the Dependent Eligibility Audit
Did you know that 5-15% of all dependents are ineligible and can be costing as much as $3,000 per dependent?  RCI can provide a dependent eligibility audit and provide a substantial savings for your self funded health plan.  Talk to your sales or account representative to receive a proposal.

Midland’s Premier Network
RCI is excited to announce the new Premier Midlands Choice Product.  Contact your Sales Representative or Account Manager for more information.
 



Welcome to Regional Care!

Regional Care, Inc. (RCI) is one of the nation’s premier independent third-party administrators.  We have continued to grow our business by offering unique products and delivering exemplary services to our clients and broker partners while managing health care costs effectively. We are based in Scottsbluff, Nebraska but our client base is located nationally. This is accomplished through use of leading-edge technology, partnerships with leading-edge business partners and staff dedicated to identifying the best available PPO networks in each geographical area.

We offer a complete portfolio of services and products either directly or in partnership, and should be considered a “one-stop shop”. With that said, we offer a high level of flexibility to our clients and their brokers in selecting ancillary services and designing benefit plans.

Cost Management:
One of the greatest challenges facing employers is controlling health care benefit cost, and that is where we excel. Over 15 years in the business has shown us that cost is only controlled when we implement a comprehensive array of strategies including:
Best-in-Class PPO Networks: We work with our clients to select effective PPO networks for all major concentrations of employees and retirees. The key is diligent review of available networks based on access to providers, potential disruption of patient-provider relationships, the quality of contracts with providers, the level of savings gained by the networks historically and the level of support provided by the PPO to Regional Care’s other cost control strategies.

Medical Management:
Our on-site nurses are supported by the resources of some of the nation’s leading medical management companies. This allows us to provide tools to covered participants to manage their health status; ensure that proposed services are medically appropriate and delivered in the correct setting; actively manage the most acute conditions; and intervene with patients who are chronically ill or non-compliant with treatment for a condition to ensure that their condition is not exacerbated.
Pharmacy Benefit Management: We are committed to partners that are ethical and transparent in their business dealings, as well as 100% focused on delivering the lowest net cost for the most effective drugs. Additionally, we do not view the PBM relationship as a separate endeavor. Our relationships are integrated administratively, clinically and financially with our other programs.

Claims Management:
We look at our client’s money as if it were our own, with each claim viewed individually as an opportunity to pay the correct amount in a timely fashion. Once a claim is received it is subject to thousands of system edits for cost, billing appropriateness and benefits. It also receives the scrutiny of our experienced processing staff and nurses and several leading edge business partners.

Client Service and Support
Over the last 3 years our client retention has exceeded 95%! This is accomplished through respecting the business needs of our clients and a commitment to the highest quality account management staff and business tools. Our Account Managers average over 10 years of experience with Regional Care and are supported by operations that understand the importance of timely, accurate and friendly service.

Nearly as important as experience is our commitment to building a relationship based on information. Our data warehouse allows for regular reporting of financial and utilization results, as well as laser-like identification of factors driving cost. Once identified, we work with our clients to ensure that corrective action is taken.

Participant Service:
There is nothing in our business as important as demonstrating compassion and respect for our client’s employees and their families. We recognize that health care is complex and sometimes traumatic. We also recognize that service will impact employee perception of their benefits and ultimately their productivity.

Our commitment begins with transition planning, where steps are taken to ensure those with special needs do not “fall through the cracks”. It continues with high quality communication materials provided to covered participants and an exceptional web site with tools for self-service and self-care. Everything culminates with our Customer Service Department, where highly-trained representatives are focused on resolving a significant percentage of issues during the call and gaining satisfied participants.

The Bottom Line
Regional Care has invested heavily in the staff, systems, programs and partnerships necessary to balance cost control with satisfaction. Our growth, client retention and health care trend results show the investment is paying off…for our clients and for Regional Care!

Cobra Certified
We also have cobra certified individuals to assist with any of your cobra questions or needs.

 

 

 

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