Consulting

AFHC Consulting Services

We make this guarantee: AFHC consultants must demonstrate savings and/or increased profitability or the client pays NOTHING for the specific services under contract.

Consultants working with Advisors For Health Care offer comprehensive consulting services for:

Employers
Health Care Providers
Managed Care Entities
Insurance Companies

For a price quote, or for more information about AFHC's complete consulting services, please call 1.770.993.3137

Or send an email message to consult@managedhealth.com (please include your name, telephone number, and a brief outline of your areas of interest).

Our Clients Have Included

• Affinity Health Group
• International Resistive Corporation
• Phoebe Health Partners
• Amlease Corporation
• Preferred Plan
• Center for Research in Ambulatory Care Administration
• Insurance, Consultants & Brokers, Inc.
• National Human Resources Committee
• Blue Cross Blue Shield of Georgia
• Consultec Corporation

Consulting Services for Employers

• Providing health care benefit designs through identifying health care benefit issues of the employer and factoring in cost concerns.
• Negotiate with reinsurance carriers for benefit designs and cost allocation including cost credits based upon network, UM and health benefit plan monitoring contracts
• Select, evaluate and negotiate Third Party Administrator Contracts for self funded programs
• Select, evaluate and negotiate Preferred Provider Organization Contracts
• Select, evaluate and negotiate Health Maintenance Organization Contracts
• Select, evaluate and negotiate Utilization Management Organization
• Select, evaluate, design and negotiate Pharmacy Benefit Management Program
• Quarterly and semi-annually monitoring and preparation of formal reports on health care utilization trends within the employer health benefit plan
• Develop disease state management program (s) based upon the medical and health care profile of the covered employees, spouse and dependents on the health benefit plan
• Independent audits of the health benefit contract - TPA, Networks, UM Company, PBM Company, etc. to determine if compliance to the contract has been achieved

Consulting Services for Health Care Providers (including Physicians, Medical Group Practices, Hospital, Physician Hospital Organization, Provider Service Organization, Home Health Care Company, Medical Laboratory, and more)

• Provide “Turnaround” and “Interim” on site management services
• Provide access to “Direct Contract” products for provider networks
• Negotiate capitation contracts with Managed Care Organizations
• Prepare Managed Care Applications (HMO, PSO) for Insurance Licensure
• Negotiate network contracts between providers of health care and employers, Third Party Administrators
• Negotiate mergers and acquisitions
• Strategic Planning in the evolutionary health care delivery system
• Financial modeling of compensation systems for providers, i.e., physicians and hospitals
• Financial evaluation of operations with proposed improvements
• Financial evaluation of contracts signed with suggested changes
• Integrated Delivery System Development

Managed Care Entities - HMO, EPO, PSO, etc.

• Provide “Turnaround” and “Interim” on site management services
• Negotiate capitation contracts between providers and the Managed Care Entity
• Provider contracting
• Special marketing programs
• Financial and management evaluation of operations
• Marketplace analysis
• Systems analysis and development

Insurance Companies - Fully Insured and Reinsurance Carriers

• Negotiate provider networks, PBM, UM contractual relationships including discounts and cost
• Auditing Third Party Administrators and Provider Networks
• Prepare special analysis on UM, Provider Networks in respect to actual utilization
• Implement significant managed care techniques and cost controls
• Prepare strategic planning in respect to health care benefit offerings
• Negotiate with Master General Underwriter’s and Master General Administrators
• Create special health care product offerings in designated geographic areas
• Relationship building between employer and carrier

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