Group Health

PPO Networks

Lutheran Preferred (LP)

  • More than 100 hospitals and thousands of physicians
  • Extensive network covering Northeast Indiana and northwestern Ohio

Three Rivers Preferred (TRP)

  • Subset of Lutheran Preferred
  • More than 35 hospitals and thousands of physicians
  • Provides the most aggressive savings offered to local employers by Lutheran Health Network

Products

  • Lutheran Preferred Choice
  • Lutheran Preferred Exclusive
  • Lutheran Preferred Exclusive Plus
  • Three Rivers Preferred
  • Three Rivers Preferred Plus
  • Special reinsurance arrangement
  • Small Group Product "Ownership Rewards"
  • Three Rivers Medical Management

The Bottom Line

While all of our products provide outpatient, inpatient and physician services, Three Rivers Preferred Plus provides Lutheran Health Network's best pricing through these enhanced benefits.

  • Outpatient Services
    • ASC Based
    • Fixed fee schedule
    • Commodity (MRI, X-Ray and CT) fixed pricing
  • Inpatient Services
    • MS-DRG based
    • Lower base rate
    • Higher outlier
  • Physician Services
    • Enhanced fixed fee schedule

Next Steps

Contact our team to provide analysis of how your current products compare to ours. Our team can perform the following to demonstrate the benefits of our products:

  • Disruption/Comparison Report
  • Network Accessibility Report
  • Network Claims Analysis

Utilization Review

Three Rivers Medical Management (TRMM). TRMM Reviews and evaluates many aspects of patient care. They determine the appropriateness of medical services and treatment delivered to individuals covered by your company's plan. TRMM's services include:

  • Precertification/pre-admission review
  • Inpatient concurrent review
  • Outpatient surgery review
  • High-cost equipment and medical supply review
  • Peer review
  • Claims review
  • Large-case management