Plan Participants

Safeguarding participants is core to each plan administrator’s fiduciary duty. Therefore, Highlight Health is always looking out for plan participants.

Most of our work on behalf of participants relates to hospital claims. We ensure that the right cost is paid by both plans and plan participants for hospital care. Unfortunately, claims for hospital care are often improperly inflated and non-compliant which means that plans and their participants are overpaying for care.

Plan participants are particularly at risk when 1) covered under plans with high cost sharing (via high deductibles and out-of-pocket maximums) or 2) covered under reference-based pricing (RBP) or other “networkless” plans that have potential for balance billing. We do everything possible to reduce a participant’s cost sharing and their risk of a balance bill.

Further, every time we save the plan and/or the stop-loss carrier money, the plan sponsor’s medical spend decreases, which the plan sponsor can convert into lower employee premiums, benefit increases, or higher employee compensation.

Our Services Are

We Find Financial Assistance Programs

Many hospitals have financial assistance programs that can dramatically reduce a participant’s cost sharing liability. These programs are often unadvertised and challenging to access.   Highlight Health identifies these programs, explains the programs to the participant, and assists them with every step of obtaining a cost reduction.

We Screen for Eligibility

Highlight Health utilizes proprietary data sets and careful analysis to determine what hospital financial assistance and other programs a participant may qualify for.

We Manage the Paperwork

Highlight Health will complete all needed paperwork and agreements on the participant’s behalf.

We Monitor Providers & Advocate

Highlight Health submits paperwork to the hospital, advocates for the participant, and monitors hospitals to ensure that discounts and savings have been applied.

Help Me Save Money