The Alliance® Partnerships: Driving High-Value Health Care, Together

We’re proud to work alongside partners that share our commitment to High-Value Health Care. Our partnerships provide employers, employees, and their families with preferred pricing and performance guarantees on prescription drug benefit management, dental insurance, and vision insurance.

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National Cooperative RX

National CooperativeRX/WisconsinRX gives employers greater value for their pharmaceutical spending with discounts, leading-edge clinical programs, a national network, enhanced data reporting, and more!

Employer Benefits

• Volume purchasing power and aggressive pricing
• Transparency and disclosure
• Flexibility through benefit design choice
• Routine claim auditing
• Clinical programs and pooled purchasing dollars to facilitate implementation of programs
• 50% reduction in enrollment fees

Delta Dental®

Delta Dental offers employers administrative discounts, flexible options, and performance and savings guarantees — all while protecting the smiles and oral health of employees and their families.

Employer Benefits

• A 7% discount on administrative fees
• Flexible employer contribution options
• Performance guarantees for customer service and plan administration
• Fully insured or self-funded options
• Additional discounts on DeltaVision® when employers offer both a DeltaVision and Delta Dental plan

Employee and Family Benefits

• Easy-to-use online directories and a toll-free phone line
• Access to a vast network of dentists nationwide
• Considerable cost savings when visiting a dentist in the Delta Dental PPOTM network
• Access to benefit summaries, claims statuses, and Explanation of Benefits
• Online access to dental and vision directories, oral health resources, and more on our convenient online member portal

DeltaVision®

Encouraging routine vision exams is critical to preventing more serious vision and health problems. Whether you offer DeltaVision on a completely voluntary basis or as a contributory plan, your membership with The Alliance generates additional discounts that provide exclusive value to your employees and their families.

Employer Benefits

• A discount on administrative fees
• Flexible employer contribution options
• Options for comprehensive plans and materials-only plans

Employee and Family Benefits

• One eye exam per year (comprehensive plan)
• Low (or no) co-pays
• Extra discounts on items not covered by the plan or once the funded benefit has been used
• Online savings on replacement contacts
• Access to a vast network of providers nationwide, including private practitioners and popular vision outlets

Out-of-Network Solution

AMPS utilizes Reference Based Pricing with three components to ensure claims are priced fairly for all parties involved: Healthcare Providers, Health Plans, and Members. We call this Fair For All pricing. The process begins with an audit of claims by AMPS board-certified Physicians. Next, AMPS determines the “best price” for each claim using multiple reference points including AMPS 15 years of claims history. Finally, AMPS balances Plan Savings and Member experience by determining the “best time” to negotiate with Providers.

A Dynamic Approach

Before a claim is priced, AMPS Physician Panel reviews each line of the itemized bill for billing accuracy. This ensures claim payment is made for services actually rendered and clinically relevant. AMPS utilizes machine-learning software to identify and remove: duplicate charges, non-rendered services, data entry errors, unbundling, inaccurate time charges, adverse clinical occurrences and hoteling days. This ensures Plans and Members are only paying for the services and care they received.

AMPS utilizes historical data, reference-based benchmarks, direct contracts, fair market value and fee-for-service pricing to calculate the “best” price for each claim. AMPS Intelligent Pricing engine can be configured dynamically to match the unique goals of each Plan.

 

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