Whether it’s driven by a performance problem or just due diligence, plan sponsors periodically need to test the market for better clinical, network, service and/or insurance arrangements. This is where our independence and deep expertise enable clients to secure truly best-in-class services, pricing, and contract terms.
► RFP + Market Bids
This is an area in which we consistently help clients achieve superior results. Our approach to market bidding values transparency, vendor flexibility to meet your specific needs and expectations, treatment quality and cost outcomes, and plan member service.
Smart purchasing is usually not about volume. It is more so about approach and expertise. We don’t run market bids through a “home office team” that shovels these out as a routine, mind-numbing practice.
We prepare thoughtful RFPs that engage bidders with well-understood and attractive new business opportunities, while using proprietary contract terms that are far more effective than conventional “tell us about” questionnaires. Bidders know they will get fair opportunities and full consideration through us, because we don’t have our own products, or books of business that need feeding to meet internal business goals.
► Contract Negotiations
Chelko takes contracting with insurance companies and service vendors very seriously and negotiating clear and effective contracts is just another one of our strengths. We believe the “devil is in the details.”
Details relating to items such as extra fees for management of non-network claims, claims fiduciary responsibilities, claims run-in and run-out, super high-cost cell and gene therapies, ownership of data, subrogation options, performance guarantees, and point solutions all need to be thoroughly negotiated.
When pricing is completed and plan changes are approved, implementation is the next area of focus. We work with clients and their vendors to make sure plan changes are properly understood, systems are correctly set-up, plan descriptions are updated, and vendors are prepared to manage and administer plans as expected.
Implementation assistance can be even more intense in situations such as a TPA/health plan or PBM change. We find regular calls and meetings crucial in ensuring commitments made during the bidding and negotiation process are met.