Self-Insured Employers

The rising cost of healthcare coupled with the aging population is presenting significant challenges for self-insured employers. NationsHealth has developed a unique solution that will assist your company with eliminating costs by successfully transitioning retirees with chronic conditions (such as diabetes and respiratory conditions) from group to Medicare coverage. We can coordinate with your PBM on this program.

NationsHealth also has extensive experience working with employers' PBMs and stand-alone PDPs to coordinate Part D programs such as Employer Group Waiver Programs (EGWP).

Our solutions provide a robust menu of operational and technical management tools. These solutions can be purchased as an entire package or a la carte, and most components are customizable to meet your specific business needs. They include:

Healthcare BPO Services

Member Engagement Center Services

• Clinical and non-clinical staffing
• Clinical and non-clinical rollover capacity
• Inbound / outbound engagement services
• Physician outreach
• On-shore and off-shore agent options
• Survey capabilities for satisfaction measurement as well as clinical data gathering
• Inbound / outbound provider engagement
• Compliance and audit services
• Health education, reminders and reporting
• Flexible thin client IT environment with robust reporting capabilities
• Automated call processing (IVR)
• Print and email campaigns
• Internet landing pages for information capture and educational content delivery

Medical Product Services

Fulfillment Services

• Fulfillment and distribution services (i.e. diabetes, respiratory, ostomy and urological)
• Specialty pharmaceutical mail order delivery program - with deep Part B experience
• Formulary development assistance
• Physician outreach
• Retail to mail conversion

Over-the-counter (OTC)

• Over-the-counter (OTC) product distribution and benefit administration
• Development of CMS compliant catalogs and literature
• Custom and special products

Part B Conversion

• Conversion of self-funded employer retirees to part B for diabetic and respiratory supplies

Distribution Engagement Services

• Proactive patient outreach to educate and encourage compliance with physician orders
  • Average telephonic patient outreach frequency of four times per year
  • Hassle Free Healthy Living program educational literature and tools delivered to patients / members as part of our mail order supply program
• We do not compete in the prescription drug space
• Medical billing and compliance infrastructure to mitigate risk

We deliver these strategic advantages:

• Outstanding reliability, scalability, and flexibility of healthcare contact services
• Multiple locations to mitigate service disruptions caused by weather or other unforeseen circumstances
• Capacity scaling expertise to allow for fast response to unexpectedly large call volume
• Multi-lingual services