Plan Administration
MBA handles all aspects of Plan Administration
for its clients. This includes but is not limited
to:
Utilization
Management
Utilization Management is comprised
of Pre-certification, Utilization Review, Case
Management and Organ Transplant procedures and is designed
to help ensure covered
persons receive necessary and appropriate health care
while avoiding unnecessary
expenses for specified items and services requiring pre-certification.
MBA draws on the expertise of a recognized
leader in health management, Strategic
Health Development Corporation (SHDC), for all its
utilization management needs. The
Utilization Management component of Strategic Health
is accredited by the American
Accreditation HealthCare Commission (URAC).
Preferred Provider
Networks (PPN) MBA
maintains contracts with the largest national preferred
provider organizations along
with many regional preferred provider organizations
to allow members access to
discounted medical services from participating providers.
MBA continually analyzes and
monitors the performance, access, and value of each
of PPN to ensure the greatest access
and level of savings to client members.
Check the back of your ID card
to determine which preferred provider network is
available to you in your area. You may also visit
the respective PPN website by clicking
on the appropriate link below. Most websites will
provide a wealth of resources and
allow you to search for local participating healthcare
providers and facilities to meet your
specific needs.
Pharmacy Benefit Managers
MBA provides great flexibility for pharmacy
prescription drug benefit needs by utilizing the services
of the largest and most recognized national Pharmacy Benefit
Managers in the industry. MBA is able to offer an array
of prescription drug plan options to meet the continually
changing needs of our clients.
Click the links below to visit each
Pharmacy Benefit Manager website or to download the appropriate
prescription drug
claim form. Pharmacare
Pharmacare
Claims form (PDF)
Express
- Scripts
Express
Scripts Claims form (PDF)
Caremark (Advanced
PCS)
Caremark
Claims form (PDF)
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