Strategies and measures aimed at controlling risk.
Cost Containment Nurse Review
Independent Medical Risk Assessments for Smarter Decision-Making
Who We Are:
Hamilton & Archer Health Services, LLC, is a trusted provider of independent medical risk assessments for stop-loss and fully insured products. With a national client base and credible data sources, we offer precise risk projections that enhance underwriting accuracy and cost containment.
Why Choose Hamilton & Archer?
Data-Driven Insights: Our extensive business blocks provide a credible foundation for accurate risk assessment, surpassing single-entity data limitations.
Flexible Support: We can serve as your primary risk assessment partner or provide overflow support during peak times, ensuring continuity in decision-making.
Expertise in Medical & Insurance Fields: Our nurses are trained in both medical cost projections and insurance, ensuring a comprehensive approach to risk evaluation.
Tailored Solutions for:
✔ Third-Party Administrators (TPAs): Improve underwriting accuracy and reduce claim costs through our independent risk projections.
✔ Insurers: Strengthen pricing models and risk mitigation with our national trend analysis.
✔ Large Employers: Gain better control over self-insured healthcare costs by proactively identifying high-cost claims.
Hamilton & Archer Health Service’s stop-loss cost containment nurses can help your organization through:
Case Management: Our Registered Nurse Certified Case Managers (RN, CCM) review and oversee high-cost medical cases, ensuring that the treatment plan is appropriate, medically necessary, and cost-effective. Our RN, CCMs monitor cases closely to help avoid unnecessary expenses.
Coordination of Care: Nurse navigators collaborate with healthcare providers to streamline care, prevent duplicative services, and ensure all aspects of the patient's healthcare are coordinated effectively.
Claims Analysis and Reporting: Our stop-loss cost containment nurses have over 70 years combined experience in analyzing medical and claims data to identify cost thresholds. Hamilton & Archer Health Service’s nurses have a deep understanding of clinical care, insurance policies, and cost-control strategies, along with strong communication skills to interact effectively with underwriters, brokers and Third-Party Administrators (TPA).
Let's Connect:
Hamilton & Archer is ready to support your risk management strategy. Let’s discuss how our independent assessments can drive better financial and healthcare outcomes for your organization.