Claims Surveillance
Same Networks, Better Care Management, Lower Costs
Reduce employer health insurance costs by 20-35% while maintaining or improving employee benefits. Access the same national provider networks as major carriers, with proactive medical management and transparent pricing that puts your employees and bottom line first.
The Employer Healthcare Cost Crisis
Employer health benefits are the 2nd or 3rd largest operating expense, yet most companies have little control over year-over-year cost increases averaging 8-15% annually.
Unpredictable Premium Increases
Annual renewal shock with 8-15%+ premium hikes. Employers absorb massive cost increases with little explanation or control, impacting budgets and employee benefits.
Lack of Cost Transparency
Opaque pricing structures and administrative fees buried in complex contracts. Employers rarely know where their healthcare dollars actually go or why costs keep rising.
Feeling Stuck with Limited Options
Most employers believe they must choose between major carriers with high premiums or narrow networks with lower costs. Few know better alternatives exist.
Rising Employee Out-of-Pocket Costs
Higher deductibles, larger copays, and reduced coverage shift costs to employees. Benefits become less competitive for talent retention and recruitment.
Our Solution – Claims Surveillance
Comprehensive health plan management combining national network access, proactive medical oversight, and transparent administration—delivering better care and significant cost savings.
Same National Networks as Major Carriers
Your employees access the same doctors, hospitals, and specialists available through UnitedHealthcare, Aetna, Cigna, and Humana networks. No disruption to care, no loss of preferred providers.
Expert Medical Case Management
Board-certified physicians and clinical teams proactively manage high-cost cases, prior authorizations, and complex treatments. 25+ years analyzing $3.5 billion in medical cases ensures clinically appropriate, cost-effective care.
Transparent, Employer-First Model
No hidden fees or opaque markups. You see exactly where your healthcare dollars go. We succeed when you save—not when you overspend.
Free Plan Analysis
Comprehensive cost review
Custom Strategy
Tailored optimization plan
Network Verification
Confirm all providers
Seamless Transition
Zero employee disruption
Ongoing Management
Continuous oversight
Average implementation: 60-90 days
- Access to national PPO networks (UHC, Aetna, Cigna, Humana equivalents)
- 25+ years medical case management expertise
- Prior authorization with board-certified physicians
- Forensic claims analysis and review
- Proactive high-cost case management
- Pharmacy benefit optimization
- Real-time claims monitoring and reporting
- Employee advocacy and support services
- Regulatory compliance (ERISA, ACA, HIPAA)
- Predictable, transparent fee structure
Measurable Value for Every Stakeholder
For CFOs & Finance Leaders
- 20-35% average cost reduction vs traditional carrier premiums
- Predictable, transparent fee structure (no hidden administrative markups)
- Direct bottom-line impact: $500K-$3M annual savings (typical for 100-500 employees)
- Improved cash flow management with stable, controlled healthcare spending
- Better fiduciary responsibility—you control where healthcare dollars go
- Reduced financial risk from unpredictable premium spikes
- Tax-deductible business expense with dramatically improved ROI
CFO-Specific Value
- Healthcare moves from uncontrollable expense to managed cost center
- Competitive advantage through lower operating costs
- Board-ready reporting with complete cost transparency
Why Choose Avande for Claims Surveillance
Proven National Network Access
Your employees access the exact same doctors, hospitals, and specialists available through major carriers like UnitedHealthcare, Aetna, and Cigna. Network equivalency is guaranteed—no disruption to care, no loss of preferred providers.
- National PPO networks in all 50 states
- Same hospitals and specialists as major carriers
- Network verification before transition
25+ Years of Clinical Expertise
Board-certified physicians and clinical teams with 25 years analyzing $3.5 billion in medical cases. We proactively manage high-cost cases, validate medical necessity, and ensure clinically appropriate care—preventing waste while protecting your employees.
- $3.5 billion in medical case analysis
- Board-certified physician oversight
- Proactive high-cost case management
Aligned Incentives & Transparency
We succeed when you save—not when you overspend. Unlike traditional carriers with profit models based on total spend, our transparent fee structure aligns our success with your cost reduction. You see exactly where every healthcare dollar goes.
- Transparent pricing (no hidden fees)
- Employer-first alignment (not carrier-first)
- Complete cost visibility and reporting
Claims Surveillance Results
Manufacturing Company - 350 Employees
32% Premium Reduction, Zero Employee Disruption
Facing 14% annual premium increases for 3 consecutive years. Employee deductibles doubled to offset costs. Benefits becoming uncompetitive for skilled labor recruitment.
Transitioned to Avande Claims Surveillance with network verification for all employees. Comprehensive medical case management and prior authorization oversight implemented.
Technology Firm - 125 Employees
27% Cost Savings, Enhanced Benefits Package
High-growth startup with escalating health insurance costs threatening profitability. Needed competitive benefits for Bay Area tech talent but premium quotes were unsustainable.
Implemented Avande Claims Surveillance with same national networks as previous carrier. Enhanced pharmacy benefits and mental health coverage while reducing costs.
Healthcare Services Provider - 450 Employees
24% Savings While Improving Clinical Outcomes
Ironic situation: healthcare provider struggling with own employee health costs. High utilization from aging workforce and multiple chronic conditions. Carrier threatened 18% premium increase.
Avande proactive medical case management for high-cost chronic conditions. Prior authorization by board-certified physicians. Enhanced disease management programs.
Frequently Asked Questions
Ready to Reduce Your Healthcare Costs?
See how much your company could save with transparent pricing and physician-led medical management
Schedule a free health plan analysis to discover your potential savings. We'll review your current costs, verify network coverage, and provide a detailed projection—no obligation, complete transparency.
- 25+ years experience
- $3.5B analyzed
- 20-35% average savings
- SOC 2 | HIPAA Compliant
