claims adjudication

Benalytics Consulting Group, LLC is an employee benefits consulting, brokerage, and administration firm based in Marietta, Georgia. Since 2005, it has supported fully insured and self-funded employers, ranging from 2 members to over 8 million, including Fortune 500 and governmental organizations. The firm is led by senior consultants and underwriters with more than 150 years of combined experience across national consulting, actuarial, and insurance firms.

benchmarkingbenefits administrationbenefits consultingbrokeragecall center and customer serviceclaim auditsData Analyticsdependent verificationfinancial modelingHR strategymulti-media campaignsplan enrollmentrate negotiationrecordkeepingRFP Managementunderwritingwebsite design and hosting

Brighton Health Plan Solutions is a healthcare enablement company offering third party administration and direct contracting services for self-funded employers, healthcare systems and regional insurance carriers. With 30 years' TPA experience, it handles enrollment, eligibility, claims adjudication, claims repricing, and other administrative tasks, and provides a customizable technology platform that integrates with health plans.

benefit designclaims managementclaims repricingcost-containment programseligibility administrationenrollmenthealth plan administrationmedical managementprovider contracting

ProCare Rx is a specialty pharmacy-focused Pharmacy Benefit Manager (PBM) that delivers comprehensive pharmacy benefit management solutions built around transparency, flexibility, and clinical excellence. It provides real-time claims adjudication operated by a US-based team, analytics, reporting, prior authorizations, formulary management, cost containment, clinical services, and rebate programs for plan sponsors including employers, insurance companies, and government programs.

analyticsbusiness intelligenceclinical servicescost containmentformulary managementprior authorizationsrebatesreporting

Essential HealthCare Solutions, LLC (EHS) is a national healthcare management and staffing company founded in 2015. It is a woman-owned small business with Federal, State and Local Government contracting experience, providing healthcare consulting, provider network development, credentialing, claims adjudication, and medical and behavioral health staffing.

contract negotiationsCOVID testing supportemergency disaster rapid medical staffinghealthcare managementmedical and behavioral health staffingmedical supply and equipment procurementPPE procurementprovider credentialingprovider network development