Services That Make a Difference

Prairie States is a leading third-party administrator (TPA) of self-funded health benefits plans purpose-built to protect your employees and your organization’s bottom line.

  • Medical Claims Administration
  • Dental Claims Administration
  • Vision Claims Administration
  • Enrollment & Eligibility
  • Plan Documents & Amendments
  • Legislative Compliance
  • Detailed Reporting & Analytics
  • Data-Driven Plan Design
  • Copay Clarity
  • Stop Loss Coordination
  • COBRA Administration
  • Short-Term Disability
  • FSAs and HRAs
  • Online Portal Tools
  • Subrogation
  • Bill Audit & Negotiation
  • Utilization Management
  • Case Management
  • Condition Management
  • Vitality Essentials Wellness
  • FiveStar Health Concierge

Performance Guarantees

  • 99% financial accuracy rate
  • Clean claims paid within 10 business days
  • 90% of calls answered in an average of 20 seconds

Or you receive a 10% fee rebate!

Data-Driven Plan Design

We specialize in customized plan design with proven cost-saving strategies to help you reach your organization’s health goals.

The foundation of plan design is data.

We’ve partnered with Deerwalk, A Cedar Gate Company, to deliver a powerful data analytics platform that empowers our clients to make enlightened decisions that reduce plan costs over time.

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59%

Average our customers have saved off of total billed charges

Integrated Health & Wellness

By keeping our health management, wellness, and concierge programs in-house, we provide unrivaled integration, responsiveness, and clinical expertise for employers and their employees.

Claims
Administration

Utilization
Management

Case
Management

Condition
Management

Vitality
Essentials

FiveStar
Health

Health & Wellness

Legislative Compliance

To keep our customers safe and secure, Prairie States provides comprehensive legislative compliance services, staying ahead of every regulatory change.

We constantly draw upon the vast resources of SPBA and SIIA to remain informed. We also work with the Phia Group and our attorney, who specializes in healthcare legislation, to review and implement state and federal legal updates.

Prairie Insights

Explore Prairie Insights today for more on our personalized plan management, proven cost-containment solutions, and dedicated staff members.

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