Why MagnaCare?

Working Hard for Working Families

For nearly 15 years, MagnaCare has been providing Taft Hartley Funds access to high quality healthcare. In that time many organizations have chosen us to help serve their membership, with our unparalleled provider network and outstanding administrative and customer services.

We are large enough to negotiate competitive fee arrangements on behalf of our plan sponsors, yet agile enough to provide the “high-touch” service and customized plan designs they demand.

We continue to build on our heritage as the preferred healthcare partner to the Taft Hartley Fund market, and as such we have made a long-term commitment to fulfill its unique needs.

We are focused on developing products and processes designed to serve Labor’s unique needs, including:

• MagnaCare Access — our provider network is among the best in the Metropolitan area
  
  
  • Over 59,000 provider locations
    
  • Over 240 hospitals, from large teaching hospitals to community hospitals
    
  • Ancillary providers such as radiology/imaging centers, laboratories and home health care providers
    
    
• MagnaCare National Access — making high quality doctors and hospitals available to your plan participants wherever they are
  • Over 4,600 hospitals in all 50 states
  • Approximately 177,000 Primary Care Physicians
  • Approximately 333,000 Specialists
  
  
• MagnaCare Plan Management — providing administrative management services, including:
  
  
  • MagnaCare Access
    
  • Claims Adjudication
    
  • Claims Repricing
    
  • Eligibility Management
    
  • Member Enrollment
    
  • Customer Services
    
  • Provider Services
    
    

• MagnaCare Pharmacy Benefit — 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 you get access to the pharmacies providing the medications you need to stay healthy.

  
  

• 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 members' needs and requirements in the pursuit of arranging for appropriate and cost effective care. We help you make better healthcare decisions. That way, quality healthcare is delivered effectively in times of need.

  MagnaCare offers a full range of programs to support the complex clinical cases within your health plan.
  
  
  • 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 Fee Negotiation — MagnaCare has assembled a Dedicated Negotiations Team to serve as your advocate in dealing with Out-Of-Network claims. Our highly trained staff is experienced in medical claims cost containment and fee negotiation. MagnaCare's industry experience with health care facilities and providers across the nation enables us to reach and surpass your cost containment goals. We are a proven leader in cost containment services and will intervene to negotiate savings on your behalf.
  
  Value Proposition:
  • 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
    
  
  Your organization has everything to gain and nothing to lose from learning more about this expanded MagnaCare service.
  
  Please call 866-624-6261 so you can immediately experience greater cost reductions.
  
  
• MagnaCare Benefits Online — opening up a new source of access and information for you and your plan participants