Cost Containment Case Study: Heart Condition

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August 28th, 2012
Categories: Case Studies

Cardiac ChartsA Brazilian tourist was visiting friends and family in the New Jersey area and was admitted to Hackensack Hospital for a heart related condition. His travel policy offered minimum medical coverage for his condition.  For the entire episode of care, about seventeen days, his case amounted to over $500,000. After conducting a claims analysis, our negotiators were able to apply our cost containment methodology to successfully reduce the claim to $30,000, paying all parties, the hospital and physicians.

PayerFusion is a Health Plan Administrator and Cost Containment company offering comprehensive solutions for self-funded employers and international payers to meet their client's needsOur services include provider network design/support, policy design (including: 24hr medical concierge, white glove service, and pharmacy network), full-service TPA, technology solutions/support and informatics.  Contact us for more information and to learn more about our health plan administration services.


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