A&G Healthcare Services Announces Successful Implementation With Pittman and Associates.
Interface provides seamless claims workflow for re-pricing/negotiation services for out-of-area medical claims
Plano, TX,,
July 18, 2007 – A&G Healthcare Services, a national leader in technology and cost containment
solutions headquartered in Plano, TX, has completed its electronic interface with Pittman and Associates’ claim
adjudication platform. The A&G interface has been tested and in production successfully for over 90 days.
The HIPAA-compliant connectivity solution provides healthcare claim payers with cost-effective, electronic access
to process out-of-network medical claims for their customers. Automated eligible claim selection and EDI claim
routing for out-of-network re-pricing and fee negotiation discounts are performed after benefit determination and
prior to claim payment, thereby reducing the number of manual adjustments required for discounts applied to nonqualified
claims.
Pittman and Associates based in Memphis, Tenn., selected A&G as one of it’s cost containment vendors to
achieve discounts for out of area/network claims. The post-adjudication interface integrates with A&G’s EDI repricing
solution, which provides electronic access to Amera-Net, A&G’s proprietary network for out-of-area and outof-
network claim re-pricing.
“We began using A&G’s Services because we needed to maximize every opportunity for out of area/network claim
repricing discounts,” said Arnold Pittman, CEO of Pittman and Associates. “It’s just a good business decision for
us to add A&G’s Services to our capabilities.”
”The environment for claims processing and claims re-pricing is becoming more complex, and payer organizations
need the efficiencies produced by our many services and electronic claims re-pricing,” said Norman Payson,
chairman, founder and CEO of A&G Healthcare Services.
About Pittman & Associates, Inc.
Since its founding in 1981, Pittman & Associates has provided quality service in claims administration and
marketing of health insurance. With an office in Memphis and a staff of more than 80 professionals, Pittman &
Associates offers a complete portfolio of healthcare benefit products and administrative services.
For more information, visit www.pa-tpa.com.
PRIME HEALTH SERVICES REACHES STRATEGIC ALLIANCE WITH A&G HEALTHCARE SERVICES
Dedicated to offering clients the right PPO and superior benefit cost management!
Nashville, TN,
(June 8, 2007) – Prime Health Services (Prime Health), a National Preferred Provider Organization (PPO), announced today a strategic partnership with A&G Healthcare Services, a full service benefit cost management company, with emphasis on access management and providing services as an access intermediary.
“Prime Health Services is excited to enter into this new relationship with A & G Healthcare. The strength of their cost management services paired with our vast PPO coverage and discounts will serve to be an asset to the A & G customers,” said Bethany Cook, Director of Business Development for Prime Health Services.
“From a technology standpoint, Prime has allowed A&G to position a ‘real-time’ re-pricing option anywhere within our many workflows,” said Greg Gilmore, Director of Information Technology for A&G Healthcare. “We jumped at the opportunity.”
About A&G Healthcare Services
A&G Healthcare Services was started twelve years ago and has evolved from a niche cost containment vendor to a full service benefit cost management company with emphasis on PPO access management and providing services as a PPO access intermediary for Primary and Secondary Claims repricing. A&G’s Amera-Net is one of the largest medical networks in the United States, with access to 65,000 hospitals and clinics, and more than one million healthcare providers. For additional information, please visit www.aghealth123.com or call 866-942-4427.
About Prime Health
Founded in 1996 and based in Brentwood, TN, Prime Health Services (Prime Health) is a managed care company that offers a full spectrum of services, including a Preferred Provider Organization (PPO) ready for access with customizable solutions, as well as repricing offerings. Prime Health’s PPOs include Workers’ Compensation, Group Health, and Auto Liability networks. Prime Health has over 500,000 providers and facilities nationwide forming the Prime Health National Delivery System. Prime Health offers our National Delivery System to the TPA, insurance carrier, and self-insured markets. More Information is available at www.primehealthservices.com or by calling 1-866-348-3887.
A&G Healthcare Interfaces with Trizetto To Process Out-of-Network
Claims for Corporate Systems Administration
www.aghealth123.com and
www.Trizetto.com
Dallas,
TX 4/27/2007– A&G Healthcare Services, a national leader in technology
and cost containment solutions headquartered in Plano, TX, has completed its interface
with TriZetto’s ClaimsExchange™ electronic payer and PPO connectivity service for
customer Corporate Systems Administration (CSA). The A&G interface operates
with the ClaimsExchange service and the QicLink™ claims administration application
in a post-adjudication environment, and has been tested and in production successfully
at CSA for over 90 days.
The HIPAA-compliant connectivity solution provides A&G’s QicLink-based healthcare
claim payers with cost-effective, electronic access to process out-of-network medical
claims for their customers. Automated eligible claim selection and EDI claim routing
for out-of-network re-pricing and fee negotiation discounts are performed after
benefit determination and prior to claim payment, thereby reducing the number of
manual adjustments required for discounts applied to non-qualified claims.
CSA, based in Johnson City, Tenn., which has been using the ClaimsExchange service
for several years, migrated to the post-adjudication EDI routing application interface
in November 2006. The post-adjudication interface integrates with A&G’s EDI
re-pricing solution, which provides access to Amera-Net, A&G’s proprietary network
for out-of-area and out-of-network claim re-pricing.
“We began using A&G’s services because we discovered that by using EDI and other
A&G Services, we could improve our workflow and save money for our clients,”
said Diana Pearce, vice president
of Operations at CSA. “In addition, A&G saves CSA significant dollars in processing
costs. It’s just a good business decision for us to add A&G’s services to our
capabilities.”
“The environment for claims processing and claims re-pricing is changing dramatically,
and payer organizations need the efficiencies produced by our many services and
electronic claims re-pricing,” said Norman Payson,
chairman, founder and CEO of A&G Healthcare Services.
A&G Healthcare Services will be exhibiting at the TriZetto Benefits Administration
Client Conference, July 29 – 31, at the Sheraton Chicago Hotel and Towers in Chicago,
Ill.