{"id":1088,"date":"2025-11-14T15:21:06","date_gmt":"2025-11-14T15:21:06","guid":{"rendered":"https:\/\/novacoremuldev.wpengine.com\/carbon\/?page_id=1088"},"modified":"2025-12-09T03:37:41","modified_gmt":"2025-12-09T03:37:41","slug":"cost-containment","status":"publish","type":"page","link":"https:\/\/novacore.com\/carbon\/cost-containment\/","title":{"rendered":"Cost containment"},"content":{"rendered":"\n
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Cost containment<\/h1>

Value-based reinsurance solutions<\/span><\/h2> <\/div>\n<\/div>\n <\/div>\n <\/div>\n <\/div>\n
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Carbon Stop Loss Solutions\u2019 Branch Program for health plans and employer stop loss cost containment services leverage clinical and medical management expertise to address high-risk cases and improve financial outcomes.<\/p> <\/div>\n<\/div>\n <\/div>\n <\/div>\n <\/div>\n

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Cost control services<\/h2> <\/div>\n<\/div>\n
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\n Risk analysis and intervention <\/h3>\n
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Using our sophisticated data analysis and reporting system, our team analyzes member health utilization and claims to identify cost drivers and trends. This allows us to provide proactive solutions to address client-specific risk to improve clinical and financial outcomes.<\/p> <\/div>\n <\/div>\n<\/div>\n\n <\/div>\n

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\n Claim payment integrity <\/h3>\n
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Payment integrity is key to ensuring correct reimbursement and requires that charges are coded accurately, appropriately documented and free from impropriety of charge. Our highly customized prospective claim payment integrity program detects, prevents and corrects provider payment issues that cannot be identified by automated claims processing edits and other programs.<\/p> <\/div>\n <\/div>\n<\/div>\n\n <\/div>\n <\/div>\n

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\n Contract intelligence for complex conditions <\/h3>\n
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We offer superior contractual intelligence and analysis to support fair and appropriate negotiations, as well as access to best-in-class contracts for complex conditions such as organ transplants, cancer therapy, congenital heart disease, ESRD and more.<\/p> <\/div>\n <\/div>\n<\/div>\n\n <\/div>\n

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\n Cell and gene therapy risk mitigation <\/h3>\n
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As an unprecedented number of therapies for rare and devastating diseases enter the market, many ranging in cost from $2M to $4M+, payors need specialty financial and clinical resources to assess and contain this novel exposure. We provide the most comprehensive, multidisciplinary, end-to-end cell and gene therapy risk mitigation solutions.<\/p> <\/div>\n <\/div>\n<\/div>\n\n <\/div>\n <\/div>\n

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\n Specialty pharmacy solutions <\/h3>\n
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Our clinical team offers expert risk analysis and management to effectively address high-cost specialty pharmacy spend. This supports optimal member outcomes and covered plan benefits.<\/p> <\/div>\n <\/div>\n<\/div>\n\n <\/div>\n

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