Medical Claims Management

APA is Third-party Administrator (TPA) that is bringing transparency and innovation to our clients. APA is flexible and adaptable, and we take a consultative approach. We partner with you to provide the TPA services, knowledge, and technology you need to maximize workflow and costs savings.

Our medical claims management approach is to provide our clients with full transparency. We provide claim level reporting that allows you to easily identify your off-site healthcare costs. With APA you get a claim level monthly report that allows you to analyze your monthly medical costs.

At APA, we take a proactive approach by offering an integrated solution that allows you to easily reconcile your monthly invoice. We make roster and eligibility authorization a simple process for your organization, saving your team precious time.

APA has the experience and capability to administer all or just off-site healthcare claims processing, including both pharmacy and medical claims. Our claims processors have over 10 years’ experience and our leadership team has over 30 years’ experience supporting Departments of Corrections and medical and prescription claims management.

Contact APA today to see how we can help you save money and time!

Pharmacy Services

APA can help manage prescription drug spend!

As drug cost continues to rise, APA analyzes your specific drug spend and will work with you to implement a customized prescription program, that reduces cost. There is no one size fits all when it comes to managing prescription drug costs.

APA will help make sure that patients acquire the prescriptions they need at prices that won’t kill your budget. APA’s solutions can be customized and include either mail-order, local pharmacies, and specialty pharmacies, or a combination of all types of pharmacies. Our goal is to make sure the medical staff and patients have access to medications in convenient and timely manner, while maximizing costs savings.

APA team has over 25 years’ experience managing, educating, and providing prescription and clinical programs to assure the best outcomes for your patients and members. Our goal is to lower costs by implementing a program that is transparent, total pass-through, and right for your patients.

APA is working with partners to directly target high-cost medications. High-cost prescription drug therapies can have a huge impact on your budget and healthcare costs. APA is working to bring innovative new medication solutions to correctional facilities that will reduce the cost on these high-cost drugs.

Contact APA today to see what type of savings we can help you find

Integrated Solutions

APA offers cutting-edge technology and consultative solutions customized to meet the unique needs and challenges of each client. Leveraging advanced analytics and proprietary algorithms, we develop innovative strategies that drive efficiency, productivity, and cost savings.

APA offers seamless integrated billing, reporting, and invoicing, that allows you to truly understand your off-site healthcare expenditures. APA will not bundle claims together and send summary invoices that cannot be reconciled. Understanding what you are paying for at the claim level is key to having a truly transparent TPA partner.

APA’s proprietary Claim Saver system has the flexibility to create custom pricing mechanisms by providers, groups, or both. We offer tailored solutions that allows us to provide visibility, real-time, into your organizations outstanding off-site medical and prescription claims, saving time and money.

At the heart of our company is a commitment to continuous innovation. We stay ahead of industry trends and emerging technologies to deliver the most up-to-date solutions to our clients. Our approach seamlessly blends innovative technology with strategic consulting, offering clients a holistic solution that addresses every aspect of their off-site healthcare claims. From implementation to ongoing support, we provide end-to-end services that guarantee optimal performance and maximum ROI.

Above all, APA is a flexible and transparent TPA partner, you can count on when you need us, contact us today!