Angela Altherr, Akeso Care Management1

GETTTING PATIENTS TO THE RIGHT PLACE
THROUGH ADVOCACY

Angela Altherr, Akeso Care Management
Medical Concierge
Service
GETTING PATIENTS TO THE RIGHT PLACE THROUGH ADVOCACY
Medical Concierge Service
Advocacy & Directional Care Solution
Proactive direction of U.S. based health
care driven by cost and quality
 Quality of hospital care varies with no correlation to cost
 Medical Concierge provides information to help make the
best, most informed decision
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
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Identification and direction to highest quality, lowest cost
provider
Schedule appointment(s) and handle all coordination with
precertification, claims, etc.
Negotiate best rate whether in or out of network,
out-patient surgical center, etc.
PROCESS – PROVIDER CALL:
Verify Information
Identify Facilities
Outbound Contact to Member
Comparison Report
PROCESS – MEMBER CALL:
Gather Information
Verify Information
Outbound Contact to Member
Within 48 – 72 hours
Comparison Report
Directional Impact
Original Facility Cost:
MCS Redirected Cost:
Case #1 – Shoulder Surgery
Case #1
4
Redirected and negotiated rate with freestanding surgery
center vs. original acute care facility.
$55,550
Case #2
Case #2 – MRI of Knee
Arranged for MRI at imaging center vs. local hospital
$6,000
5
22
25
$15,227
15
$1,250
Plan Savings:
$40,273
Plan Savings:
$4,750
Directional Impact
Original Facility Cost:
MCS Redirected Cost:
Case #3 – Arthroplasty w/Ligament Reconstruction
Case #3
4
Redirected member from hospital to surgery center
$45,550
Case #4 – MRI Lumbar Spine w/o Dye
Case #4
$4,605
5
22
25
$8,500
15
$3,105
Plan Savings:
$37,000
Plan Savings:
$1,500
Member “refused” redirection – Redirected member from
medical center to outpatient imaging center
MEDICAL CONCIERGE Service Highlights
Real ROI
Lives = 400
Plan Savings = $107,221
ROI = 35.36
Lives = 762
Plan Savings = $81,881
ROI = 14.33
Lives = 124
Plan Savings = $1,482
ROI = 1.14
Lives = 29
Plan Savings = $5,492
ROI = 17.81
MEDICAL MANAGEMENT COMPANY
OUR TEAM
Nurses
Medical Director
Representatives
Billing Specialist
Overview
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