Our SunResources program is designed to provide top-notch care to patients and claim savings for employers. Take a look at some real-life examples of how we have helped patients and employers:
Negotiating Savings on Kidney Dialysis
A TPA case manager contacted us for assistance with high drug charges for a patient receiving peritoneal kidney dialysis. Working together with the TPA case manager, we contacted our SunResources vendor who negotiated a 20% discount on these charges, resulting in net savings of $42,099 over a six-month period.
Alternative Care for a Difficult Pregnancy
SunResources is available to our customers anytime, even before a claim reaches the Specific deductible. In one such example, a patient who was 27 weeks pregnant had already used her home health care benefit for the year. Our SunResources case manager was able to put a 31-day alternative care plan in place, substituting the plan's skilled nursing benefit for the patient's exhausted home health benefit. By working with the patient's case manager, we helped keep her at home to receive her IV medications, rather than have her admitted to a hospital, resulting in estimated savings of $49,600.
Out-of-Network Hospital Charges
Out-of-Network charges can significantly drive up costs for a self-funded plan. When Sun Life Financial received claims for reimbursement for three separate out-of-network hospital stays, our SunResources case manager became involved. By working with the administrator's case manager and our preferred vendor, we were able to obtain significant discounts for this patient's care. Net savings for the three hospital admissions totaled $50,487.
