Reduce Costs, Simplify Benefits
With Brighton’s Third Party Administrator Services
Thinking About Making The Switch To Self-Funding?
Broad Expertise
Employers, Funds, and even other TPAs use our third party administrator services either in conjunction with our proprietary health plans and networks, or with health plans and networks from any other vendor or health insurance carrier.
Unparalleled TPA Expertise and Flexibility
Here at Brighton Health Plan Solutions, we help take the load off of your shoulders by bringing simple, strategic, and highly-effective technological solutions to your problems.
- Custom plan design
- High-touch account management
- Create® Technology platform
- Claim adjudication and processing
- Data transparency
- Provider network management
Custom plan design
No two clients are alike. We work with you collaboratively to tailor your health plans to your budget, members, and healthcare goals.
High-touch account management
We treat every client as our most important. Our dedicated teams will go above and beyond for you.
Create® Technology platform
Our state-of-the-art healthcare technology includes a highly configurable open enrollment platform, member and administrator service tools, and a mobile app with real-time data feeds. The proprietary software allows members to maximize their benefits and allows you to more easily manage them.
Claim adjudication and processing
We administer your health plan any way you want, and can accommodate special arrangements such as benefit tiering. We process more than 10.1 million claims each year with 99% accuracy, and use strong auditing tools. Our average client retention rate of more than 10 years attests to our expertise in claims adjudication and claims processing.
Data transparency
Using our advanced technology platform, you receive actionable data in real-time. Easily run reports for at-a-glance information on key demographic and utilization metrics that help you discover trends and control costs.
Provider network management
An expert team configures, maintains, and audits our proprietary networks and your custom networks to ensure they meet adequacy requirements and our clients’ standards. To better serve their patients, our providers connect to our online provider portal and interact with our US-based provider customer service staff.
How We’re Different
Here at Brighton Health Plan Solutions, we help take the load off of your shoulders by bringing simple, strategic, and highly-effective technological solutions to your problems.
Enrollment, eligibility, and ID cards
Through our Create Technology Platform, enrolment and onboarding are a breeze.
- We manage all eligibility files for you
- We handle ongoing hours reconciliation and contribution accounting
- We produce tailored ID cards delivered by mail through our mobile app. (If you produce your own ID cards, they can be made available digitally.)
Superior Customer Service
Our Concierge Customer Service team is in charge of:
- Helping members understand their plan in order to obtain the right care suited for them
- Helping members find providers, schedule and coordinate appointments
- Helping your members navigate benefits, bills, and others.
Competitive Stop Loss Coverage
Our strong relationships with Stop Loss partners help our clients achieve competitive Stop Loss insurance coverage. Or we can integrate seamlessly you’re your preferred Stop Loss vendor.
Custom Communication Materials
Through our Create Technology Platform, enrolment and onboarding are a breeze.
- We design custom enrollment materials and communications
- Coordinate meetings and webinars that help educate members on their health plan options
- Help engage members in their benefits
Entrust your COBRA administration to the experts
COBRA is a complex benefit with strict regulations. Remain compliant and avoid penalties by offloading COBRA administration to a TPA with expertise and keen attention to detail. We can assume the responsibilities for your COBRA benefit – including preparing and distributing all documentation and communications, monitoring election periods, and collecting monthly premiums.
Frequently Asked Questions About Direct Contracting Healthcare
What is direct contracting healthcare?
Direct contracting healthcare is a model that fosters direct relationships between health systems, employers, and providers. It streamlines care delivery, bypassing traditional insurance intermediaries, and focuses on improving patient outcomes.
How does direct contracting improve patient care?
How does direct contracting benefit self-funded companies?
Who else benefits from direct contracting healthcare?
Health systems, employers, and patients all benefit. Health systems can deliver care more efficiently, employers save on healthcare costs, and patients enjoy a seamless care experience.
What role does Brighton play in direct contracting healthcare?
How does direct contracting reduce fragmented care?
Is direct contracting healthcare suitable for every health system or employer?
Get In Touch
We’re here to help you streamline your health plan administration. Whether you have questions or you're ready to explore a solution tailored to your organization, fill out the form and our team will be in touch shortly.
