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Welcome to Regional Care!
Regional Care, Inc. (RCI) is one of the nation’s fastest growing
third-party administrators. We have grown over 25% in each of the
last two years based on delivering exemplary
service to our clients while managing health care cost 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!
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