Benefits Administration
Demonstrated Value and Effective Outcomes
Shasta provides comprehensive administrative services utilizing innovative software applications, technology-based solutions and an ever-expanding knowledge in employee benefits. Our philosophy of providing superior quality, cost containment and customer service gives us the flexibility to fully customize internal processes so that the results are EXACTLY what our clients want.
The following are some of the services Shasta offers:
Claims Administration
Medical, Dental, Vision, COBRA, FSA, MLR, CHEF, 340B, Federal Supply Schedule, RX Mail Order, Available Integrated Behavioral Health (IBH) & Tiered PPO Network, Customized Service Plans
Claims Management
Stop-loss, Subrogation, High Dollar claims, Wellness, Network Management, Medical Management, Claims Scrutiny, Edits, Auto-adjudication, Unique Integrations, Best in class vendors, Net Cost, Opportunity Analysis Review
Compliance
Dedicated Manager; ERISA Consulting Attorneys, Self-initiated SSAE16, HIPAA, COBRA, ACA, 1099’s, Discrimination testing
Customized Communications
SPD, EOB’s & ID Cards, Educational materials, Web, Specialized ID Cards, Other Payers, Providers, Participants, 24 hour turn-around, Communication on plan, billing and/or claims, Eligibility Coordinator: One-on-one service response, PPO exceptions assistance
Online, paper and electronic enrollment, Tracking/Reporting, 100% accuracy, COBRA within 14 days of termination/notice; Exceptions
Eligibility Maintenance
Tribal Clinic, Purchased Referred Care, Electronic Solutions for Participants, Providers, Human Resources, Brokers. Custom Reporting, Indian Health Services Reporting
Data Reporting Provided To:
ADDED VALUE
Shasta can assist with strategic planning and plan design, facilitate interaction with key vendors and other Shasta clients to discuss process enhancements, previous successes and analyze health plan cost utilization and provide recommendations.
“Shasta is absolutely helpful and go above and beyond; in my opinion.”