Claims Administration/ADR Advisory
DonnCo advises self-insured municipal and corporate entities on bundled and unbundled claims/managed care program restructurings and vendor selections. Understanding the hidden economies of both claims and managed care, we ensure that your bundled program is optimized in all areas, and that improvements to one service line are not lost through slippage in another. We provide superior expertise in all areas of claims program operational and financial performance, as well as ADR program advisory and development.
• Identify and recapture managed care fee overcharges and overpayments to medical providers.
• Financial analysis to compare the profitability and structural fit of multiple managed care program models (for clients considering several program options).
• Financial analysis to determine whether self-containment for a managed care program makes financial, organizational and/or strategic sense.
• Specific enhancements to the design and structure of an existing program.
• Specific analysis of fee structure and savings performance.
• Targeted advisory on specific managed care program issues.
• Guidance on the relevance and impact of legislative and regulatory changes.