DirectCARE allows both individuals and employer sponsored health plans to purchase health care services directly from providers. We cut out the middle-man and save the employers 20% to 60% off their health care spend.

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We communicate directly to the health providers with fair and reasonable pricing and direct contracts.  You get your choice of a Major Medial health plan with the medical and pharmacy coverage you expect and optional alternatives or gap plans like Indemnity, First Dollar, MEC Compliant (Minimum Essential Coverage), Stand-Alone RX and Direct Primary Care (DPC)

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DirectCARE is dedicated to helping members navigate their health care experience. Health plan enrollees never have to question their coverage.

Technology and telephone access to a Care Concierge to answer any questions and provide support including:

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Finding a Provider

Confirm network status of providers and coordinate scheduling and transportation

 

On-Demand Provider Network

See one of 900,000+ contracted providers OR... let us create an on-demand contract for the personal care you seek

 

Quality Physician Referrals

Receive primary care and specialist recommendations based on patients needs. Confirm availability, appointments and acceptance of payment

 

Support Direct Contract Options

Maximize the utilization of the high quality, high value providers

 

Verify Benefits and Coverage

Explains and resolves billing issues, denials and balance bills

 

Out-of-Pocket Assistance Program

Receive member discounts and payment plans for Out of Pocket expenses

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Incentive Management Program:

• Continually engage members promotes clinical, emotional, and financial wellness

• Saves money and increases member satisfaction by supporting Center of Value utilization

• Reduces employer’s medical spending by + 6% - 12%;

• Employees save 40% on Out of Pocket & 15%-80% per Episode of Care

• The only program that supports network optimization, direct contracts and variable incentives

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Proactive Population Health Management 

• Identifies avoidable spending ER, Branded Rx, High Cost Providers

• Improves Rx Compliance and Reduces Population Health Risk

• Monitors Screening compliance and identifies gaps in care

• Offers a proactive outreach program