CASE MANAGEMENT
Our medical case management services ensure that patients receive the appropriate care while increasing opportunities for cost savings.
Complete Admin Health Plan Solutions
CLAIMS MANAGEMENT
PayerFusion’s medical claim management services are designed to minimize administrative burden and reduce your overall cost per claim.
COST CONTAINMENT
With our cost-plus methodology we produce superior savings for our clients by leveraging real cost and quality data mined with our own unique algorithm.
PROVIDER NETWORK
Reliable individual and group coverage globally and in the US, groups are ACA compliant with no waiting periods and no exclusions for pre-existing conditions.
SPECIALTY SERVICES
Provide your members a higher level of care and benefits through our customizable specialty services.
TECHNOLOGY
PayerFusion’s Claims Management Software utilizes Intelligent Technology to make you the expert.
Health plan administration solutions designed to maximize savings, reduce administrative expense and provide access to quality healthcare.
PayerFusion provides a full range of health plan administration, cost containment and medical claims management services to self-funded employers, international insurers and assistance companies. We employ a proprietary cost-plus pricing methodology and access to our privately owned provider network to secure the greatest savings possible for our client partners. Our unique approach includes a strong emphasis on provider relations and improving patient satisfaction with the process of accessing quality care.
- Better Provider Options – The PayFuseNet network is without walls. No quality provider is excluded, and top performing providers are ranked (by quality and cost) to help you make informed choices.
- Savings – Our innovative medical claims processing, health plan administration and cost-plus pricing methodology results in superior cost containment, helping you to control the average cost of your medical claims now and over time.
- Compliance and Peace of Mind – We provide you with expertise and thought leadership so you can stay current with constantly changing state and federal health plan administration laws and regulations as the U.S. healthcare system continues to evolve.
- Unparalleled Customer Service – PayerFusion has a culture of excellence. Adhering to ISO and Six Sigma Standards, we aim for 100% patient, payer and provider satisfaction.