Solutions for Carriers/ASOs

The Transparency in Coverage Rule and No Surprises Act are a catalyst in driving a massive shift in the health benefits ecosystem—creating a new consumer-first healthcare marketplace. It is imperative to offer your clients a full-compliance solution that can be implemented easily and without disruption, enhancing your members’ digital experience and engagement with your organization.

THE FACTS:

  • Transparency Rules are here, and your employer clients are on the hook!
  • Employers are facing $100 per day, per member fines for noncompliance if their Carrier/ASO partner fails to deliver upon the requirements.
  • Healthcare costs have grown at a rate double that of Americans’ incomes for decades, with no end in sight!
  • The growing burden of cost is coupled with worsening and widespread pessimism about healthcare and the healthcare experience.

The time to act is NOW.

For health insurers and Administrative Service Organizations (ASOs), TALON offers the ultimate suite of software services designed to seamlessly fulfill the requirements of the Transparency in Coverage Rule and No Surprises Act, while also providing the complete experience and benefits of a consumer-driven healthcare digital marketplace. This means optimizing access and affordability of care and delivering increased healthcare consumer engagement and satisfaction.

You Should Be Asking Yourself the Following Questions:

  • Are we providing the appropriate protections and guidance to our clients so that they are compliant with the Transparency in Coverage Rule and No Surprises Act?
  • Does our transparency partner take care of multiplexing and layering all our negotiated rate agreements, so the shopping experience identifies ONLY the correct price based on the plan documents?
  • Can our system deliver the required shopping experience, including accurate estimates of encounter costs both at plan-level and subscriber level, leveraging the value of the network your organization has created?
  • Are eligibility updates, plan design feeds, consumption accumulators, QPA and Advanced EOBs fully automated?
  • Have we protected ourselves and our clients from costs for accessing and downloading publicly accessible files?
  • Have we architected a compliance solution that scales and will work for the long-term?

“Maybe” isn’t good enough. If you can’t answer each of the above questions with a definitive YES, we need to talk TODAY.

TALON Offers MORE

  • Scale your business and outplay your competition.
  • The TALON system creates free-market dynamics, starting with subscriber engagement through alignment of incentives, providing true ROI.
  • TALON seamlessly meets all requirements for machine-readable files and advanced EOBs.
  • The unmatched digital experience provided by TALON’s innovative MyMedicalShopper  platform EMPOWERS employees to become informed consumers and make smart, economical decisions about their own care. See MyMedicalShopper in action.
  • As an added incentive for choosing low cost, high-quality care, TALON’s patented and intuitive MyMedicalRewards™ program rewards employees through HSA/HRA contributions or gift cards. 
  • TALON integrates with existing systems with little to no distraction or disruption.
  • TALON protects employers from overpaying for care, lowering overall healthcare spend by 20-40%!

TALON provides a long-term solution for full compliance, lower costs, and better care.

We are here to help! Our team of experts is ready to work with you to ensure your groups’ compliance and safe harbor.

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