Facts to Leverage

Claims Processing

At PAI, we take customer service seriously. Our self-funded groups are assigned to dedicated customer service units, so your group leaders will personally connect with their unit supervisor and a team that is familiar with their group’s benefit plan. We track performance metrics daily to ensure we are meeting high standards for turn-around time, first call resolution, payment accuracy, and customer service quality. Our processes include a statistically valid sampling of claims that is audited for quality control. All claims over $10,000 receive additional review.

LevelOne: Alternative to Self-Funding

Now PAI has an option for groups who want to test the waters before self-funding their benefit plan. This is a great option for employers with a level monthly budget for their health care plan. Download the flyer for more information.

Networks

For your employees in South Carolina, PAI offers the state’s largest insurer’s Preferred Provider Organization (PPO). Our PPO network offers unparalleled access to hospital and physicians throughout the state, and negotiated fees that average between 30-48% below billed rates. 

For your out-of-state employees and dependents, or traveling employees, PAI can put together network solutions that ensure your plan members will have access to discounted fees. 

Pharmacy Benefit Plans

PAI also administers pharmacy benefits, utilizing top pharmacy benefit management firms, including Caremark, Smith Premier Services, Benescript, Express Scripts, and PartnersRx.  These pharmacy networks feature deep discounts from average wholesale prices. Plans can be structured with tiered co-payments to encourage use of generic, preferred drugs, or mail order where possible. When group members show their ID card at participating pharmacies, they don't have to file claims or wait for reimbursement.