Colorado Choice Health Plans and San Luis Valley HMO can
meet the needs of employers who require Self Funded and other
financial arrangements – We provide Third Party Administration
with a choice of networks, stop-loss/reinsurance carriers
focusing on managing your health care costs. We can design
a plan that works for your company with a choice of funding
options. Basic Services include:
Eligibility management
Claims payment
Utilization Review/Pre-cert
Cobra Administration
Quarterly reporting
Services that can also be provided include:
Acute inpatient Medical and Surgical Review
Acute Inpatient Psychiatric Review
Concurrent Review
Discharge Planning
Large case management
Outpatient Surgical Review
Potential Shock Loss Notification
PPO Channeling
Readmission Review
Reconsideration & Appeal
Retrospective Review
Substance Abuse Review
Reporting
Quarterly Reports – basic services
Ad Hoc Reporting – Varying pricing
