Highlight Health is redefining cost containment for self-funded health plans. We save money for plans and assist plan sponsors in fulfilling their fiduciary duties. Our solutions focus on the large medical claims that dominate healthcare costs, including inpatient claims, outpatient procedure claims, and large professional claims.
Highlight Health works directly with health plans to protect the financial interests of plans and their participants. We don’t contract with organizations who might restrict the advice and services that we offer our clients. Our conflict-free services utilize innovative technology, data analytics, and deep expertise within the healthcare payer system. We apply complex laws, rules, and regulations to analyze billed healthcare charges and obtain the best possible price for our health plan clients. We provide documentation and defend our work which is always supported by citations.
Our health plan clients save substantial amounts of money and gain satisfaction from being responsible fiduciaries of plan funds, by identifying fraud, waste, abuse, and overpricing — and then doing something about it! Most of our fees are a percentage of savings, guaranteeing alignment of interests and return on investment.
Protect Your Bottom Line
Healthcare costs are the second largest line item for most employers in America. You can partner with Highlight Health to safeguard your plan, obtain greater information and transparency, ensure payment integrity, and understand what you are paying for and how your dollars are being spent – while saving healthcare costs.
Unlike many other health plan cost-saving opportunities, our savings are fully transparent and immediate. You don’t need to call a consultant or hire an actuary to estimate how much you might save in the future. You can directly see how much you saved last month, last quarter, and last year.
All Health Plan Sponsors Welcome
We work exclusively in the self-funded health plan space and understand that plan sponsors are diverse. Some are very large organizations with a large benefits management department, and others are quite small, perhaps with only a single responsible employee or vendor managing benefits.
Highlight Health works with private enterprises, non-profits, governments and governmental subdivisions, unions, church organizations, and tribal organizations. Whether a plan is covered under ERISA or not, all plans have a fiduciary duty to assure that plan and participant funds are appropriately spent. We are glad to help the plan administrators of any plan exercise their fiduciary duty and sure that the health costs they are paying are correct.
Highlight Health also works on behalf of both network and reference-based pricing (RBP) health plans. Network contracts do not prevent us from doing our work! In fact, under the Consolidated Appropriations Act of 2021 and subsequent federal guidance, it is illegal for networks and other parties to block a health plan and its vendors from reviewing claims.
We Work With Claims Administrators
Highlight Health works with third-party claims administrators (TPAs) or administrative services only (ASO) claims administrators, and can recommend services providers to our clients.
We encourage you to read more about our services!