We're here to answer your questions.
Established in 1983, Med-Pay is the longest running, individually owned and independent Third Party Administrator in the state of Missouri. The management team is dedicated to providing the highest quality service expected by all of our clients. All members of the management team have each been employed for at least 10 years.
No middle person to confuse communication or increase fees.
All TPA services and staff are centrally located in Springfield, Missouri.
Client and member walk-ins are welcomed and expected.
In-house claims processing system allows maximum flexibility for a wide range of benefit plan options, optimizes the ability to retrieve data for analysis and meets the multitude of clients’ reporting requirements. Our system complies with federal regulations including, but not limited to, ERISA, COBRA, HIPAA and PPACA.
Customized web site for employees to access claims information and links to major health care related web sites.
Most reports are available in printed and text file (Excel compatible) options which can be emailed or posted on the secure web site for delivery to the client.
Many additional advisory or consultant services are included in the admin fees: compliance to state/federal laws (PPACA,COBRA, HIPAA, USERRA,FMLA, Workers’ Compensation, etc.), employee meetings and other employee communications.
Subrogation department investigates accident claims for other insurance liability and files liens for claims eligible under the plan.
Provides prospective analysis based on past history recalculated at new benefit levels. Provides retrospective plan year study compared to previous year at plan year’s end.
Staff case managers are on-site in Springfield and available to the members. They work with families and physicians as an advocate for the covered patient.
Many utilization review services performed are included in the pre-certification fee. Employer approves recommendation for large case management (LCM) before case management services are performed. Services include negotiating all of a LCM person’s out-of-network claims, if any.
Pharmacy benefit manager is involved to provide the pharmacy network, utilization review, reports, mail-order service and specialty drug pharmacy.
Claim appeals and reviews are handled by trained staff. When an outside review is required, appropriate professionals are consulted.
Additional services available include self-funded, dental and vision plans, and flexible spending account services. When a client has both self-funded and FSA plans, the claims are automatically processed from one to the other when the claims are funded. Claims are processed for a specific day every week for each client. Additional days can be added for special registers.
Also administer Health Reimbursement Arrangement Plans.
Helpful staff is available to answer questions and assist in special requests. A list of employees’ names, phone/fax numbers and e-mail addresses will be available to you.
The Med-Pay Difference
We're here for you.
Our Customer Service representatives strive to make everyone feel comfortable asking questions.Our response time is second to none.
Clients and Associates have virtually "24/7" access.
Our representatives are personally available to talk with your associates Monday through Thursday, from 8:30 a.m. to 4:30 p.m and Friday 8:30am to 4:00pm CST. Our professional answering service takes messages at all other times. Web Services available 24 hours a day at med-pay.com.
Med-Pay's nurses are pro-active.
Their expertise makes them the leaders in assuring that the most appropriate quality care is provided in a cost-efficient manner.
In-House Precert and Utilization Review
The opportunity to implement case management actually begins with that first precertification call. Our nurses work with your plan, your associates and their health care providers to effectively manage your health care dollars.
We make compliance easier
We provide comprehensive services to assure that all those compliance requirements are met. We notify terminated participants of their COBRA rights and responsibilities. HIPAA Certificates of Coverage are sent to terminated participants, with subsequent notices provided as necessary. We maintain the billing and record-keeping for you.
Better than those "canned systems".
By developing our own in-house software, we can meet the ever-changing demands of our healthcare system.Our system is user-friendly.Our on-staff programmers know how important it is to have information that makes sense. Plus, our system capabilities are practically unlimited.