4C Digital Health

4C is the undisputed leader in providing independent financial oversight, control, and accountability for large states and corporations with self-insured plans.


What is 4C Digital Health?

4C Digital Health is a transparency partner that enables self-funded medical plan sponsors to own and understand their medical plans data. Our mission is to bring access, oversight and opportunity to our clients as they collaborate with benefits consultants, point solutions, and claims administrators. Plan sponsors have fiduciary duties to their members and 4C helps plan sponsors make those responsibilities by ensuring claims are billed appropriately by providers, process appropriately by carriers, and invoiced accurately when they're ultimately paid. Beyond oversight of medical claims themselves, 4C ensures programs, fees, and point solutions are delivering the expected value, as well as being charged back to the plan appropriately. So, things tie out on the backend as they should. For example, we've seen instances where major carriers have overcharged by literally millions of dollars due to misconfigurations in the way shared savings programs are being billed.

How is 4C Digital Health different?

First, 4C is independent. We are independent because we work exclusively for self-funded plans, so you can be assured our perspective is unbiased and unconflicted. Second, 4C is focused. 4C is focused exclusively on the needs of your plan. Our client success team will take the time to understand what makes your plan different, and we will tailor our engagement to your unique needs. And third, the scope of 4C's analysis sets us apart. We review every line of every claim to ensure providers bill correctly, carriers or TPAs process claims appropriately, and ultimately, invoices paid by the plan reflect the fees and services properly. And lastly, and most importantly, 4C's people set us apart. With team members coming from a host of different backgrounds, ranging from clinical settings, machine learning, major carriers, government, academia, data science, we're well suited to realize any opportunity for our clients.

Who is a good fit for 4C Digital Health?

A self-funded plan fiduciary should seriously consider 4C, to help them understand and oversee their plans performance. Having an objective understanding of your plan is invaluable. We work with clients as large as the state employee plans of Florida, Virginia, and Kentucky with billions of spend reviewed, down to plans with several thousand members. If you are self-funded, if you have a data warehouse or you're thinking of investing in one, we're the solution for you. The day of statistically insignificant claim audits and vendor self-reporting is over. Plan sponsors should expect more, and with the perspective 4C offers, you can expect more meaningful collaboration with your benefits consultants, claim administrators, point solutions, and members. If you'd like to learn more, please visit our website at 4Cdigitalhealth.com. Thank you.

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Duration: 02:51

Posted: Friday, April 12, 2024

Video tags: 1001 - 2500 EEs, 2501 - 5000 EEs, Over 5000 EEs