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Frequently Asked Questions

What differentiates INETICO in the market place?
  • Innovative & Integrated Solutions
  • Complete Care & Claims Resources
  • Collaborating, Clinical & Data Optimization
  • Accountable, Quantifiable Outcomes
  • Access & Transparency
  • Proprietary Web-Based Portal
How do you promote engagement?  We struggle with that.
  • Our Octane Wellness
  • Compliance-based incentive programs ensure greater member participation, enhancing clinical outcomes 
  • Total integration of care & claims data, providing the greatest financial impact for plan members
  • Proactive identification of candidates at risk or with chronic conditions for targeted outreach & program enrollment
  • Identification of high-risk diagnosis triggers & early ID of third party liability claims at precertification
  • Personalized approach generates member satisfaction
  • Customize incentives for Disease Management
How does INETICO save money by offering claims & care management solutions?
  • Effective PPO network assignments & Medicare referenced reimbursement rates
  • Simplified claims routing & integrity based negotiations equal the greatest opportunity for savings
  • Primary & wrap network assignment based on geographic location
  • Member utilization results in highly effective claim cost containment at member level
  • Medicare based payment supported by the appropriate plan language
  • Member ID cards & INETICO's Patient Payor Services create substantial savings for the plan
  • Greater options for members & simplified payments to the provider
How is your care review any different that what I currently use?
  • Red Flag triggers + Early Intervention
    (Prenegotiation, predialysis treatment capture, out-of-network to in-network redirection, preclaim intervention)
  • Prospective review of claimants medical status & proposed procedures
  • Determination of medical necessity & prior negotiation of cost containment opportunities
  • Concurrent review performed during inpatient hospitatlization to evaluate future intervention
  • Discharge planning ensures patients receive the best care using the most appropriate health services 
  • Retrospective review alignment with medically necessary care & post service negotiations 
Does INETICO still offer Claims Negotiations & PPO Administration?
Since being acquired in 2017 by United Claim Solutions, INETICO now mainly focuses on Care Management.  United Claim Solutions, the Nation's Leading Medical Cost Containment & Claims Flow Management company now handles all aspects of claims management. We are happy to help, as together, we offer a complete, end-to-end solution for our clients.
What is INETIPASS?  How do I gain access?
INETIPASS is our proprietary, web-based system integrating care & claims data. Please contact your INETICO Account Manager to gain access.
What does URAC Accreditation mean?
As a URAC accredited organization, we are a select group of organizations nationwide that have worked to meet rigorous standards for quality & accountability.  URAC's accreditation programs focus on a wide range of healthcare services, & each product has its own unique set of requirements & standards. Their mission is focused on developing evidence-based measures through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare.