Self-Insured Health Plan Savings

At T.E.A.M., Inc. we are able to reduce costs in several ways:

Maintaining and constantly expand a Preferred Provider Network with negotiated discounted rates that average up to 44% below current retail prices
Reviewing high-cost cases for clinical and fiscal appropriateness
Developing, with input from the benefit Fund, one of many 'gate-keeping' models designed to increase the number of members that use T.E.A.M. prior to accessing mental health and substance abuse benefits. Some common models include:

100% 'gate-keeping'. All members accessing services are required to contact T.E.A.M. prior to benefit access. Through assessment, we determine if the presenting issue is one we can resolve at no additional cost to the benefit Fund or needs to be referred to an outside provider. 40% of such issues are resolvable within our organization.
60%-80% incentive plan. In this model, a member would receive a higher level of coverage (80%) for services if they first contact T.E.A.M. Without initial contact with T.E.A.M., reimbursement would be at 60%.
A clearly stated 'cap' on mental health and substance abuse services per year with any extension to those services decided through medical necessity through T.E.A.M. and communicated to the Third Party Administrator.

Assisting benefit Funds in reviewing and resolving appeals for service. In most cases T.E.A.M. is able to negotiate appropriate care in such a manner that meets the needs of all parties and/or provides professional rationale for necessary denial of care when appropriate