Flexible, Multi-tiered Approach to Transplant Management

As the nation’s leading provider of transplant benefit management services, U.R.N. leverages over 46 million lives and its expertise to offer access to the most advantageous provider contracts available. To address all the needs identified by clients, U.R.N. has developed a multi-tiered approach for transplant patient management, which includes the following: Transplant Resources Services

TRS provides individuals in need of transplant services with access to expertise through the U.R.N. Transplant Centers of Excellence Network (COE). The COE Network is evaluated annually to help ensure that only those programs that excel in transplantation participate as members. The COE Network developed through U.R.N. offers the highest quality of care for patients, greater volume for providers, and lowest total cost for payers. Clients typically experience an average savings of 43% per transplant episode as compared to industry standard transplant costs.

Transplant Access Program

TAP was developed to address the challenge clients face when their members decide to use a non-COE Network transplant program. TAP provides geographical access and economic relief through prearranged contracts for transplantation at medical centers through the US.

Supplemental Contracts (Extra Contractual Services )

U.R.N.’s contracting expertise is available on a case-by-case basis through Supplemental Contracts, when a patient referral falls outside of both the COE and TAP Networks.  U.R.N. is able to negotiate discounts at these facilities for transplants and related services to provide economic protection for clients. U.R.N. is able to negotiate an average discount of 35% of billed charges.

Specialized Physician Review

Specialty physicians are available to review clinical information related to requests for transplantation and congenital heart disease (CHD) surgery/treatment.  Clients may elect to receive one or three written opinions by board certified, actively practicing physicians regarding the appropriateness of the transplant or CHD surgery/treatment. The clinical status and proposed protocol are addressed. Each clinical summary includes disease treatment statement, literature review, alternatives to care and community standards.

TransAdvise

A single phone call lets clients reach a U.R.N. nurse to request consultation regarding transplants, CHD surgery and complex cancer care. The nurses have extensive experience in the area in which they consult and have access to the most updated information regarding the types of care provided in each U.R.N. facility.