Medical and Cost Management: With most groups, 20% of the group’s population contributes to 80% of the healthcare benefits plan cost.

To help clients contain healthcare expenditures, RightCHOICE Benefit Administrators has developed a medical management solution that offers sophisticated programs, such as, 24/7 Nurse Line, Disease Management, and Predictive Modeling. These programs enable our clients to better work with their high-risk population, with the goal of reducing the risk of substantive claims from these high risk individuals.

On the cost management side, RightCHOICE offers clients a program that focuses on the up-front cost control through network negotiations, fraud detection, subrogation, hospital audit and overpayment recovery.