The DMS solution is available for any self-funded health insurance plan, whether a dialysis situation exists or not. One dialysis claimant can cost an employer’s plan more than $1 million per year. Our services are easy to implement and have produced dramatic results for our clients. Our focus is to eliminate waste and add value to the bottom line. All self-funded plans can benefit from implementing such a program as a proactive measure.
In addition to the savings on dialysis claim costs generated by DMS, Amwins offers several other services aimed at lowering costs and preserving plan assets for self-funded plans. Key products and services include dialysis management solutions, pharmacy audits, medical audits and dependent eligibility audits.
The DMS program components below are helping clients save more than 75% off billed charges on average.
A June 2022 Supreme Court ruling illuminated the significant issues in the widely accepted dialysis care for-profit models. While legislation that would impose new coverage requirements does not appear to be included in the 2023 Omnibus Spending Package
at this time, significant challenges for patients and insurers are still very much in play.
One of our TPA partners introduced DMS to one of their large hospital system clients who needed assistance managing escalating dialysis claim costs. The client had nearly 10,000 employees but even at that size was still unable to negotiate or access reasonable discounts from the dialysis providers in their local area. Over the prior 2 years, the client had 4 or 5 active dialysis patients each month and paid over $7.5 million in dialysis claims.
They were spending an average of about $850,000 per patient per year and that was AFTER the PPO discount. They needed a solution to this major expense problem.
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