Transparent Health Marketplace is the workers’ compensation industry’s fastest and easiest way to source thousands of quality healthcare providers.
THM gives insurance carriers, TPAs and employers access to market-driven pricing from an expanding marketplace of quality providers. We connect injured workers with the best possible care while assuring you will never overpay for ancillary healthcare services.
Our vendor management and claim submission tools integrate easily with your existing systems to make THM seamless with your workflow. Reduce time and workload by having access to all case documentation in one location. Now adjusters and nurse case managers can easily submit and document claims, comply with client requirements and compare quality outcomes and other benchmarks all in one easy-to-use interface.
Gain new operational efficiencies and cost savings.
THM can help you save both time and money. Our automated platform minimizes the administrative burden and cost of coordinating medical care and our reverse auction engine ensures you never pay more than market price. In addition to bottom-line results, adjusters can reclaim more of their valuable time to focus on claims management resolution.
While THM grants payers direct access to thousands of quality providers, we are not a network. THM does not hold static contracts with providers. Instead, THM enables you to define the “best value” by configuring the weighting for which criteria (e.g. price, performance, availability and distance) are considered when our proprietary reverse auction engine sources provider candidates. THM then facilitates spot-bidding to contract with the optimal provider for each referral.
Our client testing has proven that THM can renormalize cost/price ratios and generate double-digit percentage growth in additional savings for our payer clients.
Our Platform as a Service (PAAS) model allows you to determine the type and degree of integration, with options ranging from a stand-alone web portal and email updates to comprehensive real-time connectivity whereby THM becomes a seamless extension of your claims system and processes. A single channel for referrals via a universal, pre-filled form eliminates the need for network referral instructions and portal logins. THM administers scheduling, post-appointment follow-up, automated updates and document/billing management, to ensure the adjuster has timely notification and access to all pertinent updates and documentation.
Services currently available in the THM marketplace include diagnostics, durable medical equipment, home health, physical medicine, translation and transportation.
Yes, today THM exclusively serves the workers’ compensation industry. In the future, we plan to extend our platform into group health to allow patients to purchase medical services directly.