Run a dynamic copay plan on your network
Activate a new plan design with your existing network and claims engine. Real-time eligibility, bundled adjudication and one member bill enabled by Handl.
4 months
Avg. time to go-live
150
Episode bundles
5
AHPs in market
Everything a dynamic copay plan needs in one pipeline
Handl connects plan design, eligibility and adjudication so a new plan can go live on your existing network without member disruption.
From finalized design to a plan that runs
Configure the plan
Load your finalized design — tiers, copays, episode definitions — and Handl stands it up as a live, sellable plan configuration. No custom build.
Connect your network
Your new plan runs on the network you already contract and feeds your existing claims and adjudication platform. Providers verify tier and bundled price through the Handl portal or your existing 270/271 transaction.
Go live and adjudicate
Each episode resolves to a single member copay and a single bill. Members are steered to Tier 1 care at the point of referral, and your team monitors performance from day one.
A plan members actually know how to use
Every dynamic copay plan comes with a customizable Member Navigation built in. Members see one copay price and their best-value care options at the moment they need care, not after the bill arrives.
What does it take to build a dynamic copay plan?
Episode adjudication engine
Every episode of care resolves to one member copay and one bill, adjudicated on Handl’s episode logic and passed to your claims platform.
- 150 episode bundles across chronic and procedural care, ready to adjudicate
- Single bundled copay per episode, with back-end reconciliation across providers
- Event-based adjudication that feeds your existing claims system
Score and tier every provider
Score every provider by episode, site of care, clinical quality, efficiency and cost into a Value Index, then rank them into tiers.
- Value Index across clinical, efficiency and cost
- Scored by episode and site of care
- Every provider tiered, beyond the big systems
- Builds on the claims and network data from your network evaluation
Provider connectivity
Your tiers only create savings if they’re honored where care happens. Easily make tier and bundled prices visible to providers at the point of care.
- Handl provider portal or your existing 270/271 eligibility transaction
- Real-time tier and bundled-price verification
- Works with your established provider directories
Runs on your network, feeds your systems
Launch on the network you already contract, and keep pricing and underwriting with your actuaries.
- No new provider contracts. Activate a plan on your existing network, including national/BlueCard access for out-of-area members
- Structured inputs feed your actuarial and underwriting workflow; you own pricing
- Integrates with your existing claims and adjudication platform
Built in navigation and monitoring
A dynamic copay plan only works if members act on it, and you can prove the savings. Navigation and monitoring come connected out of the box.
- Point-of-referral steerage to Tier 1 providers. Learn more
- Continuous provider-cost monitoring and payment integrity. Learn more
- Group and provider reporting for plan sponsors
Frequently asked questions
Launch a dynamic copay plan in months
Book a personalized demo and learn how Handl can activate your new plan.