Administrative Services Only

Self-Funded Fee-for-Service Plans
Healthplex's administrative service programs meet two important needs that exist for most self-insured organizations - administrative support and expert guidance. Our experience is unsurpassed when it comes to designing and implementing custom dental benefit packages. We can help you select from - and control - a broad range of features, including deductibles, maximums, waiting periods, covered services, reimbursement levels, eligibility requirements, as well as limitations and exclusions.

And because dental is our only business, we pay attention to every detail and follow your plan specifications to the letter. When you combine our skills with current technology, the result is quality service at a reduced cost. Your enrollees receive the exact benefits to which they are entitled and you benefit from the savings.

The low fees for our administrative service will be significantly outweighed by the reduction in dental expenses you can expect with Healthplex on your team!

Call us at 1-800-468-0466 or email at groupservices@healthplex.com so we can tell you more about our administrative services and how we can save you time and money on your dental benefit.

Healthplex identifies and tracks all controlling parameters in a dental plan including:

• Frequency of service limitations
• Age limitations on eligibility and procedures
• Duplication of services
• Individual/family deductibles and maximums

Healthplex administrative services include:

• Plan development and design
• Actuarial determinations and recommendations to raise or lower future costs based on current and projected experience levels
• Professional review of claims for appropriateness of care and alternative methods of treatment
• Correspondence with providers
• Predetermination of claims
• Claims adjudication
• Coordination of benefits
• Producing and mailing Explanation of Benefits (EOB) vouchers and checks
• Claim history maintenance
• Utilization review by procedure, patient and/or provider
• Complete periodic utilization reports
• COBRA benefit processing
• Direct linkage to client computer systems
• Customer Service Department for toll-free patient inquiries

Healthplex is fully equipped to maintain your dental program on a streamlined basis that actually reduces your internal administrative costs. We provide you with the kind of management that keeps your costs in line while delivering superior service to your employees or members. And for even greater efficiency, all paper-based records are maintained on a laser-based document imaging system. While your members or employees may never know about our advanced system, they will appreciate the prompt and efficient service it enables us to provide.

Colgate dental cream was packaged in collapsible tubes in 1896.