OUR SERVICES

NHP CAN

• Administer Your Present Program
• Help Redesign Your Present Program
• Process Your Claims
• Provide Professional Consultation
• Help Reduce Costs
• Provide PPO Access Nationwide

TOTAL HEALTH BENEFIT PROGRAM INDEX

GENERAL CLAIMS PROCEDURES

• Eligibility
• Coordination of Benefits
• Subrogation of Benefits
• Professional Review

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HOSPITAL PROGRAMS

• Negotiated Hospital Discounts
• Pre-Admission Certification
• Pre-Authorized Length-of-stay
• Continued Stay Review
• Concurrent Review
• Discharge Planning
• Restrospective Review
• Hospital Bill Audit
• Peer Review
• Utilization Profiling
• DRG Appeals

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MEDICAL PROGRAMS

• Physician Network
• Specialist Network
• Second Surgical Opinion
• Utilization Profiling
• Claims Review
• Peer Review

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DENTAL PROGRAMS

• Dentist Network
• Specialist Network
• Pre-Authorization Program
• Peer View
• Utilization Profiling
• Treatment Verification Examination

PRESCRIPTION PROGRAMS

• Pharmacy Network
• On-Line Submission
• On-Line Adjudication
• Mail Order Chronic Medication Central Fill, for maintenance quantity dispensing
• Volume Purchase Discounts

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HOME CARE PROGRAMS

• Durable Medical Equipment
• Personnel (i.e. nurses, attendants, therapists)

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LABORATORY SERVICES

VISION AND HEARING AID PROGRAMS

AND ALL OTHER PERTINENT HEALTH CARE SERVICES

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