Managed Care
Managed care has emerged as the central focus in current efforts to control spiraling health care delivery costs.
Solution – Global Exchange, through a number of strategic relationships, has combined the resources of some of the nation’s top specialist firms in the industry to ensure the highest quality and total care for our insureds/members while maximizing medical cost reduction to the benefit of all payers.The program is comprised of the following:
Utilization Review and Case Management
Precertification, Utilization Review and Medical/Disability Case Management services are provided by physicians, nurses and other health care professionals. A toll-free telephone call to (800)-468-7648, available 24-hours daily, activates this essential service and puts the resources of the health care specialists at the disposal of patients and medical service providers. They work with the dual purpose of achieving maximum cost containment and ensuring that the patient’s need for the finest care available is met.
Preferred Provider Organizations (PPOs)
Our PPO relationships are four of the largest and most progressive PPO networks in the United States and include many Centers of Excellence and Organ Transplant facilities nationwide and in selected sites overseas. They all provide services to our clients at pre-negotiated (discount) rates. This allows our clients to enjoy highest quality care at most competitive rates. For health care services received in the United States our PPO networks, each with Internet access, are as follows:
| PPO | TOLL FREE NUMBER | LINK | |
|
888-342-7427 | www.multiplan.com | |
|
800-922-4362 | www.multiplan.com | |
|
800-687-0500 | www.healthsmart.com | |
 |
212-581-8228 | www.starhealthcarenet.com |
Clients seeking medical attention in the respective states are advised to click on the applicable Network’s hyperlink and follow the directions within the website for a listing of the service providers (physicians, hospitals and ancillary service centers) nearest to their locations.
Managed Prescription Drug Services
We also have a direct relationship with the largest independent full-service pharmacy benefit management company which provides managed prescription services including drug card and mail service prescription drugs through integrated retail pharmacy and mail service programs throughout the United States – Express Scripts, Inc. (ESI). With member pharmacies which include all major pharmacy chains nationwide, Express Scripts, Inc. provides prescription drugs to our clients at discounted prices. Clients are advised to visit the ESI website at: www.express-scripts.com for listings of network pharmacies and additional drug management information.
| PRESCRIPTION DRUG NETWORK | TOLL FREE NUMBER | LINK |
 |
800-245-4357 (Pharmacy Desk) 800-451-6245 (Customer Service) |
www.express-scripts.com |
In keeping with our one-stop-shop objective Global Exchange offers our clients this combination of the most dynamic and successful national managed care service firms. In combining their various specialties, they provide the highest quality care and services to the patient and, through integrated efficiencies, achieve maximum cost control for all payers – insurers, Plan sponsors and patients.