Risk Management

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Blue Water Benefit Administrators pursue excellence for our clients with our complex Risk Management Services program.

This value-added service provided by BWBA, is unrivaled and supported by decades of experienced professionals providing consultative services which protect the interests of employer-sponsored benefit plans and the plan participants.

With BWBA, clients get more than just transaction managers– our team provides custom risk management services.

Value-Added Service Unique to BWBA

Our unparalleled management of complex risks and benefits adds value to our plans in the most effective way possible. We offer highly technical solutions that go above and beyond traditional administrative services. In addition, our experts are highly skilled in the sensitive art of defending and managing our plans.

Best-in-class User Experience and Customer Service

Our clients routinely commend our customer service team for providing exceptional customer service. Our team is dedicated to the client and member satisfaction.

100% Success-Rate

Our experts can identify unique risk conditions and secure clinical resources to manage and direct appropriate
care. In addition, we provide access to specialty providers at negotiated rates and utilize claim analytic data to make recommendations for patient education and appropriate sources of care. Plus, we offer eligibility risk management and the application of alternative sources of coverage.
Case Example #1

A newly diagnosed patient was administered an infusion therapy drug scheduled to be administered every six months thereafter. Billed charges of $143K were payable at a net rate of $62K after the application of the network discount. Our team, working with specialty drug sources and a clinical Case Manager to support the patient, executed delivery of the infusion therapy medication to the administrating provider rather than sourcing from the facility pharmacy.

As a result, the new billed charge amount for the second and subsequent treatments was reduced to $31.6K, and the net payable was reduced to $21.5K. A claim cost savings of $40,630.57 – every six months.

Case Example #2

A pediatric patient required a specialty procedure. In cooperation with parents, a clinical Case Manager and third-party medical director identified a less invasive procedure available at a specialty hospital. Although still experimental, the specialty provider had a record of successful clinical trials. As a result, we negotiated a flat case rate with the facility at a rate lower than the traditional procedure. In addition, the facility agreed to assume any expenses in excess of the flat rate. Cost was 55% of the standard procedure cost while the patient benefited from quicker recovery based on the less invasive nature of the procedure.

Case Example #3

Plan participant diagnosed with the need for organ transplant services. Our consultative team arranged for specialty review at an alternative facility with higher positive outcome data. Upon confirmation of diagnosis, the patient preferred to utilize the second opinion source, and our
team negotiated a flat case rate for the procedure. The negotiated rate allowed the patient to receive care from a provider with higher clinical outcome ratings without increasing the cost to the Plan.

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