TRISTAR MANAGED CARE

TRISTAR Managed Care (TMC) offers all services necessary to successful management of your health care program, including:

Medical Case Management

TRISTAR Case Management is defined as the establishment and coordination of a treatment plan that is medically appropriate and to enforce the application of the treatment plan through our Bill Review component. We are committed to improving the quality of care and controlling costs while managing treatment to ensure optimum outcomes.

TMC is able to provide our clients with medical case managers in order to maintain contact with employees, doctors, claims professionals to control medical utilization, obtain enhanced injured employee compliance with optimal treatment protocols, and expedite return to work.

Case Management consists of the following services:

• Utilization Review
• Early Intervention/Telephonic Case Management
• Field Case Management
• Peer Review

To learn more about TRISTAR Medical Case Management click here.

Medical Bill Review

TRISTAR Managed Care (TMC) provides medical bill review services, access to local and regional PPO Networks and Medical Case Management. TMC’s managed care program can, by our estimate, effectively reduce the current medical losses at least 10% above industry benchmarks because of TMC’s high level bill review, BillChek and superior PPO discounts.

To learn more about TRISTAR Medical Bill Review click here

Network or PPO Access

TRISTAR accesses various networks and has the ability to develop a network for our clients that serve to drive higher penetration rates and higher savings. Many of our inpatient facilities have HMO discounts that are the deepest discounts available. In addition to a national network of medical providers and facilities, TRISTAR provides access to a Durable Medical Equipment, Radiology, and Pharmacy Network. Our networks may be accessed via the Internet, and information regarding providers can be given to the client members. Bill Review and PPO Network Access reports are given to the client that demonstrate to the client the billed charges, fee schedule reductions, PPO Discounts, penetration and utilization statistics.