BCI TPA Services

BCI'S THIRD PARTY ADMINISTRATION SERVICES

BCI provides a full range of administrative services to single employer and multiemployer clients.

BCI Administration Services

Claim administration of self-funded Medical, Dental, Vision and Disability benefits
Administration of Health Reimbursement Account (HRA) plans
Administration of Section 125 Flexible Spending Account (FSA) plans
COBRA administration
Contribution collection and eligibility administration
Preparation of Plan Documents and Summary Plan Descriptions
Full plan administration including the services listed above plus all other administration functions required for proper and complete plan administration

Personal and Responsive Service

Personal attention devoted to each client
Single claim processor dedicated to each client
Customer service staff comprised of experienced claim processors
Direct access to principals
Low employee turnover
All claim administration performed in BCI's office by BCI staff (never outsourced to foreign countries)

Prompt Claim Payment

Prompt claim turnaround with all claims adjudicated within Department of Labor claim procedure standards
Will tailor to client's cash flow requirements

Flexible Claim Procedures

BCI provides a check register to client for approval prior to release of checks
Client may select percentile used for determining usual, customary and reasonable fees for non-network providers

Aggressive Claim Management

BCI employs only experienced claim processors, who are alert for client cost saving opportunities
Subrogation - Performed by BCI in house for lower fees than those typically charged by other TPAs and outside vendors
Medical Necessity - BCI aggressively enforces plan medical necessity provisions using our business partners, Medical Review Institute, a URAC-certified review organization, Medical Services Management, a St. Louis-based case management firm and local healthcare providers that practice within the scope of the treating physician
Early identification of potential large claims and prompt referral to case management and excess risk carrier
Negotiation of discounts with non-PPO providers
Specialty drug management - BCI works with case management to refer patients to less costly providers for their high-cost specialty drugs
Coordination of benefits - Thorough investigation of potential duplicate coverage through other employment and/or Medicare; determination of primary /secondary payor status based on plan provisions and federal Medicare Secondary Payor rules

Wellness Programs

Together with its business partners, BCI offers a full range of wellness programs including:

Technological Capabilities

EDI Direct system enables BCI to receive claims electronically in HIPAA-compliant format without the expense of a separate clearinghouse
WebQ system gives clients, members and healthcare providers secure access to claim information via the Internet

Management Reports

Managed Care Organizations

Choice of PPOs and HMOs in Missouri and Illinois
Negotiation of (or continuation of existing) MCO contracts in other areas where there are concentrations of employees
Choice of national PPOs elsewhere

Excess Risk Insurance

BCI works with many high-quality excess risk carriers and is approvable by virtually any carrier a client may wish to consider

Pharmacy Benefit Managers

BCI offers a choice of preferred PBMs and is able to work with any PBM a new client may currently be using

Legal and Regulatory Compliance

BCI is fully compliant with all applicable legal and regulatory requirements, including HIPAA Privacy and Security regulations

Fees

Client Satisfaction