Effective protection against the high cost of transplant claims
MTP combines access to the Optum nationwide Centers of Excellence transplant network with specialized clinical expertise and years of claims adjudication knowledge. This offers unmatched cost management and risk protection against the high cost of transplant medical expenses.
- High-cost care: Average billed charges range from $409,000 to $2.6 million, depending on transplant type.
- Significant health plan exposure: For a 100,000-life group, there is $13.2 million of transplant exposure.
- Transplant utilization on the rise: 1 in 5,600 members will experience a transplant.
- Experience and scale: We have over 30 years of experience managing transplants.
Related expenses are covered through one-year post-transplant
Mitigate risk
- Reduce transplant mix risk.
- Reduce risk of high transplant volumes.
- Reduce risk of transplant complication costs.
- Reduce re-transplantation risk.
- Reduce risk of reinsurance trend increase.
- Reduce risk of clinical, case or claims errors.
Control costs
- Lower reinsurance premium costs.
- Minimize payers’ cost via coordination of benefits.
- Outsource case and claims management.
- Eliminate deductibles.
- Eliminate average daily maximums (ADMs).
- Reduce dual deductibles in consecutive years.
- Minimize time to transplant and related costs.
Maximize patient outcomes
- Reduce length of stay, time to recovery.
- Reduce unnecessary transplants.
- Maximize pharma compliance.
- Specialized physician review improves options.
- $2 million or unlimited benefit ensures full coverage.
Mitigate risk
- Reduce transplant mix risk.
- Reduce risk of high transplant volumes.
- Reduce risk of transplant complication costs.
- Reduce re-transplantation risk.
- Reduce risk of reinsurance trend increase.
- Reduce risk of clinical, case or claims errors.
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