Products and Services

MagnaCare Access

MagnaCare Access is our network of providers, offering a vast choice of doctors, hospitals and ancillary providers who are carefully reviewed and credentialed. Extending throughout the New York and New Jersey region, the network offers access to the providers that your clients and their participants need for any situation. These include general practitioners, specialists, community and teaching hospitals, labs, radiology providers, home healthcare and behavioral health providers.

• We have over 59,000 provider locations and are expanding each day
  
  
• We are proud to work with over 240 teaching and community hospitals in the region
  
  
• Additionally, we have ancillary providers such as radiology/imaging centers, laboratories and home health care providers
  
  

We can provide your clients and their plan participants with the broadest access to quality providers at significant savings that help your bottom line.

We are proud to have one of the highest-rated healthcare networks in the New York/New Jersey area. Virtually all of our providers - doctors, hospitals and ancillary providers - stay with our network year after year.

We have systems in place to maintain that position:

• Customer-specific recruitment. We have implemented a process where customers can request specific providers be added to the network, enabling us to continually ensure our members have the highest quality providers, and the ones they want, in our network.
  
  
• Database management. Using technology, we can examine our database to determine if rates are competitive; analyze codes that frequently come in; and modify fee schedules while maintaining our high level of desirable providers.
  
  
• Dedicated hospital contract team. We have an entire team whose sole purpose is to work with hospitals and improve our deals/costs with them, which ultimately saves money and opens options for our customers.
  
  

MagnaCare National Access If your clients' company has employees that reside or are traveling outside of New York or New Jersey, but are members of the MagnaCare family, we have them covered. MagnaCare's National Access Solution can help them no matter where, no matter what the need. So you can have confidence that the same caliber of providers you expect to see at home are also available nationwide. MagnaCare National Access also helps your clients' employees while they travel to points across the country, for any reason.

• Over 4,600 hospitals in all 50 states
• Approximately 177,000 Primary Care Physicians
• Approximately 333,000 Specialists

MagnaCare Health Advocacy Programs

MagnaCare Health Advocacy Programs, offering a set of products and services that arrange for delivery of quality care in an appropriate setting, at a competitive price. We apply our extensive expertise and understanding of your clients' needs and requirements in the pursuit of arranging for appropriate and cost effective care. We help your client make better healthcare decisions. That way, quality healthcare is delivered effectively in times of need.

• Pre-Admission Certification assures that only patients with a medical need for hospitalization are admitted on an inpatient basis. Pre-admission testing and same day surgery are authorized whenever possible.
  
• Concurrent Review for necessary hospitalizations assures that the length of time spent in the hospital is appropriate, and based on established norms, which are considered in conjunction with the patient's age and medical condition
  
• Discharge Planning is initiated early during the hospitalization to permit patients to go home with the care they need to permit a safe and early discharge.
  
• The Surgical Review Program identifies unnecessary inpatient and outpatient surgical procedures through physician review.
  
• The Outpatient Medical Review Program provides a prospective review of high cost medical procedures and services to determine if they are medically appropriate and necessary.
  
• The Prenatal Risk Management Program is designed to promote healthy maternity outcomes through education, prenatal care and identification and management of high-risk cases.
  
• Large Case Management Services identifies those major cases where more personalized, intensive intervention can result in considerable savings while assuring medically appropriate care for critically ill or injured patients.
  
• The Disease Management Intervention Program identifies, assesses, and monitors the patients most severely affected by chronic conditions such as asthma and diabetes.
  

Magnacare Pharmacy Benefit Management

One of the fastest growing expenses in healthcare is the cost of prescription drugs. MagnaCare's Pharmacy Benefit Management offering, like our high quality provider network, is unparalleled. We offer a range of solutions from single-source pharmacy access to mail-order prescription filling services that offer significant savings while ensuring your clients get access to the pharmacies providing the medications they need to stay healthy.

MagnaCare Benefits Online

MagnaCare Benefits Online is a unique resource that helps employers and employees manage their benefits via our website, privately and securely. Your clients' employees can get answers online regarding deductibles, claims status, enrollment status, and access to many other critical tools to enable them to gain better control over their healthcare needs.

MagnaCare Fee Negotiation

• Competitive percent of savings pricing
  
• Increased savings and revenue preservation
  
• Reduced exposure to costly Out-Of-Network claims
  
• Prior client approval of all negotiated fee agreements
  
• Archiving of all agreements to avoid potential provider disputes