iNetico - Intelligent Claims Solutions

PPO Administration

iNetico delivers unprecedented savings to you by identifying the most appropriate primary network for your groups and members. Our detailed Geographic and Claims analysis program specifically pinpoints which network is most appropriate for your group. This detailed analysis can even identify specific members that may require alternate networks access to provide you with the highest possible savings. Since iNetico is an independent PPO relationship manager, we present the greatest savings opportunity to you through our national, regional or local PPO network partners.

Care Management

INETICARE encompasses iNetico’s Care Management program. This unique clinical savings strategy ties together four care components: Utilization Management, Case Management, Disease Management and Clinical Claims Data Mining. While these services can be carved out, their savings power exists with the unified goal to produce the best clinical outcome for the patient.

Electronics Claims Management

iNetico’s Electronic Claims Management program offers multiple claims flow opportunities, through Claims Scanning, On-Line Claims Archiving and Web-based Repricing. iNetiPass our advanced web portal allows you to reprice claims online anywhere, anytime. Home-based claims analysts? Multiple office locations? Traveling? Vacationing? Inetico's electronic solutions put you in the driver's seat but adapting to the modern work place. iNetiPass is so easy to use, that you can securely access your claims information anyplace you have an internet connection.

Out of Network Negotiations

iNetico’s experienced negotiation team takes the task of handling non-network medical claims out of your hands and directly negotiates with the providers on a case-by case basis. iNetico’s analysts achieve savings similar to contracted managed care discounts on facility and on professional fees by negotiating services prospectively, concurrently and retrospectively. These savings are always over and above what you would have otherwise paid at 100% or what you would have paid after usual and customary allowances. iNetiPass, our web-base claims management tool gives you a live look as our experienced staff delivers savings results. Negotiated settlements are completed within an average of 5 business days in cases where an adjustment is possible. iNetico negotiates all claims regardless of dollar amount.