Cost Management

 

SISCO clients enjoy 17% lower total costs than the industry benchmark. The difference is the SISCO experience.

 

 

 

 

Cost Management

 

The professionals at SISCO use a variety of tools and services to manage the cost of your benefit plans and medical claims. Through these cost management services, SISCO clients enjoy total costs that are 17% lower than the industry benchmark.

 

 

 

Strategic Bill Review

 

Medical bill review is at the heart of reducing the cost of claims. SISCO offers a strategic bill review process that focuses on the amount you are asked to pay, not the discount.

 

SISCO's Approach:

 

Audits & Negotiations

SISCO identifies errors and excessive charges by auditing 100% of bills over $15,000 for medical necessity, billing accuracy, and reasonableness. One out of eleven bills include error or excessive payment demands.

 

Out-of-Network Claims

Out-of-network claims can be a significant cost driver. SISCO examines all claims to ensure they are medically necessary and billed appropriately. If your plan isn't billed correctly and reasonably, you could be paying for more services than you should be.

 

 

Subrogation

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Subrogation

 

At SISCO, we provide expert internal subrogation, very different to the industry trend of outsourcing recovery to law firms. We also offer subrogation staff as an integrated component of our claims management service.

 

SISCO's subrogation savings are 308% of the industry benchmark.

 

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Reference Based Pricing: Common Myths

 

Do you believe these common reference based pricing myths? This quick read is a great tool to check your understanding. Download this free poster to learn:

  • If RBPs are "all" or "nothing"
  • Details around balance billing
  • What the member experience looks like
  • And more

Download Now

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Eligibility Audits

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Eligibility Audits

 

 

SISCO Eligibility Audits identify ineligible dependents and reduce overall costs. SISCO combines leading-edge technology with precise attention to detail to provide a solution to the complex task of auditing and verifying dependent eligibility. Our enrollment professionals work directly with participants to reduce HR workload and ask the hard questions that are absolutely critical for eligibility determinations. On average, 4-8% of dependent spouses & children on employer sponsored benefit plans are not eligible for the medical benefits they receive.

 

Why conduct an Eligibility Audit?

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Cost Control

 

Identify ineligible dependents that should not be covered under the plan and save money

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Peace of Mind

 

An added benefit allowing employees to verify their coverage is confirmed and valid

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Compliance

 

Satisfying the fiduciary and compliance responsibilities on the plan by ERISA and Sarbanes-Oxley

 

 

SISCO Case Study

Healthcare Provider Saves Over $1.8 Million Annually

 

SISCO's Eligibility Audits help reduce costs by identifying people who do not quality for your plan's coverage. Check out this case study to see how SISCO helped a nationally recognized healthcare provider cut healthcare costs while keeping employees happy.

 

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SISCO manages our benefits so we can focus on managing our business. They help us control costs and simplify the benefit process.

SISCO CLIENT