Our Services

We help you leverage the attributes of a captive to better manage your health care benefits. We ensure that your choices work both for you and advance the goals of the larger captive membership.

Captive Risk Pool
The captive shields you from shock claims and returns 100% of underwriting profits to the members. We make sure new members are vetted, and that the pool continues to grow.
Provider Networks
We help you determine which provider networks work best for you in your local environment.
Pharmacy Network
Our pharmacy benefits manager provides a managed solution that includes the major retail chains as well as a mail order program for maintenance medications, and proprietary programs to help control the costs of specialty medications.
Claims Review
Key to our model is our expertise in monitoring and reviewing medical and pharmacy claims to ensure accuracy, as well as our commitment to intervene on your employees’ behalf as needed.
A-rated Stop-loss Insurance
This third layer of our model protects you above the limits of the captive.
Custom Plan Design
Our solution allows you to tailor your plan requirements based on your culture and your preferences.
Health Risk Assessments and Biometrics
After we collect and analyze enough meaningful data on your population, we can introduce population management strategies and tactics that identify gaps in care and track your participants’ compliance and health achievements.

Comprehensive Analytics and Decision Support

The Vxtra solution goes beyond simply delivering Destiny+. It’s the way we manage Destiny+ that makes such a difference. We leverage surveillance software, technologies, and processes to constantly analyze utilization and claims cost. You’ll have access to more timely, customized, and actionable decision support reports. With the facts in hand, we’ll help you make decisions about how to manage your plan to support your employees’ health and reduce wasteful spending.

Data Analysis & Reporting – Insurance companies typically use auto-adjudication software to process claims as quickly as possible. We leverage technologies, processes, and people to analyze claims differently because we think getting it right is more important than getting it done fast. We scrub your data in four steps:

  1. We categorize your claims. The first step to understanding your data is to sort it. We use more discrete data collection methodologies that identify the type of service and by service provider so you can assess the information you most need to best manage your health care plan.
  2. We show you where the trends are. How healthy or unhealthy are your employees? What specific challenges are they facing? Where are the gaps in care? We’ll let you know.
  3. We look for ineligible claims. Our claims surveillance looks for mistakes of all kinds – from inappropriate coding to fraud – saving you from wasteful spending that doesn’t help improve the health status of your employees.
  4. We benchmark your claims. Once we identify your trends, we compare your practice to the most advanced benchmarking data available in the market so you can address the unique health status issues of your employees.

Advanced Clinical Analysis – We approach clinical analysis from four different directions, so you have a 360-degree view of emerging health conditions within your practice. We bring to the table Johns Hopkins Adjusted Clinical Groups (ACG) Case-Mix System, McKesson gaps in care, Truven Analytics and Risk Scoring – and it’s all part of our standard service offering. A far better approach than simply auto-adjudicating  claims, as most TPAs and  insurance companies do. We’re discovering the issues, and introducing solutions to the problems based on superior data collection, sophisticated surveillance software, and big data analytics.

Plan Modeling & Forecasting – With the information from your data analysis and clinical analysis, we suggest interventions targeted to your practice’s trending health issues. You pick the approach that’s best for your practice and your employees. When’s the last time your insurance company suggested customized approaches to making your employees healthier?

Employee Communications

We understand that your resources are limited, which can make it tough to explain to your managers and employees alike the new opportunities before them. That’s why we take care of employee communications for you – and help you increase employee engagement. When you select a [Destiny+] plan, we arm you with:

  • Talking points for managers about self-funding
  • Education for employees about the move to self-funding
  • Benefits enrollment guide, explaining the medical plans and how to enroll
  • Benefits enrollment reminder poster for your breakroom
  • Patient-to-provider letter about self-funding and claims filing
  • New employee benefits welcome letter