UCM's Digital health platform is disrupting health care and creating a brand for its clients that stands for affordable, accessible, and personal care.
Enter your Personal Health Dashboard, a unique,fully integrated technology suite designed to assist in establishing a healthy lifestyle while increasing productivity and reducing healthcare.
Prodigy's custom built information data storage platform houses all the valuable information of HMA’s Clients.
Our services manage the cost and utilization of prescription drugs to improve the value of the plan sponsor’s drug benefits.
Our provider networks offer the flexibility of seeing a doctor, specialist, or facility in your region.
Our revolutionary Health Risk Model is able to detect the unknown condition before it becomes a symptomatic disease and a large claim. This allows us to continue to renegotiate with Re-Insurance carriers year over year.
Prodigy offers unique cost based pricing services and consumer transparency to reduce your employees healthcare costs and save your health plan significant money.
Medication management tool for patients on cardiovascular medications. An inspired team challenging the status quo in the healthcare technology industry.
•Pre-service estimate program
•Local and regional area price comparisons
•Both the providers and members know the reimbursement levels before any services are performed
•Eliminates most post-service negotiations
•Dramatically shortens the claim lag which benefits stop loss carriers
•Fully automated processes and procedures
•The pricing engine utilizes extensive data to determine the prevailing price, cost and value for specified medical services
Our custom built information data storage platform that houses all the valuable information of Prodigy's clients. Our online portals make managing your company’s health plan an easier process.
Features:
•5010 and ICD-10 Compliant-Ready
•Real-Time Claims Processing
•Real-time Reporting
•Consolidating OOP maximums
•Real-time Workflow Management
•Plan Building Capabilities and Testing
•Claims Pricing for a variety of networks
Prodigy offers additional tools, such as disease management that target specific clinical health problems. We offer an unmatched suite of proven PBM solutions. Our complete spectrum of services can be configured to meet each client’s specific needs. This flexibility gives our clients the ability to select the services that make sense for them.
Pharmacy Benefit Management Services:
•Preferred Medication List / Formulary Support
•Consumer Education Tools and Information
•Prescription Claim Processing
•Call Center Support (Electronic, Online, Real-Time)
•Nationwide Network of more than 50,000 Pharmacies
•Mail Order Options
We provide our clients with access to a wide range of Preferred Provider Organizations (PPOs) in order to meet the needs of their employees, from large national PPOs to the best regional networks.
Prodigy has access to over 80,000 participating providers throughout the United States, including physicians in all specialties and most of the country’s finest hospitals.
.•Our Network Solutions: Primary Networks
•Complementary Networks
•Specialty Networks
•Non-Network Solutions
•Centers of Excellence
•Network Management Services
Prodigy utilizes proven innovative pricing technologies allowing healthcare payers to optimize reimbursements for all healthcare transactions by benchmarking claims. The pricing engine utilizes extensive data sets to determine the prevailing price, cost and value for all medical services. Simply stated Prodigy provides for a fair Cost–Up reimbursement level.
All of your current providers are eligible:
•Technology is based on cost plus pricing
•Provide highest value on Member protection
•Claim surveillance examines every claim automatically and benchmarks results against Medicare pricing, cost, average reimbursements, or commercial claim payments
•True claims cost management solutions based on federally reported cost information
•Price is negotiated and sign-off agreement is secured based on reduced amounts
•Not dependent on reimbursement negotiated by somebody else
Our revolutionary platform is aimed at fighting disease and providing the support you need along the way. By participating, our members work towards a healthier lifestyle while earning great health rewards.
Prodigy offers effective ways for businesses to reduce costs through a variety of health management tools. Our products and services successfully predict and manage the members medical health risks, while working to reduce the employers cost of heavy health and pharmacy utilization.
Prodigy brings an unmatched combination of experience, knowledge, risk management, technology, and dedicated customer service to its clients. Our administration provides complex in-house services such as claims processing, account management, health services, customer service and more.
