Advantica Awarded NCQA Certification for Utilization Management

CLEARWATER, Fla., May 23, 2013 /PRNewswire/ -- Advantica, a leading ancillary benefits company, today announced the successful renewal of its National Committee for Quality Assurance (NCQA) Certification in Utilization Management for eye care services.

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As an eye care benefits administrator, Advantica employs utilization management strategies to deliver high-quality services to its health plan clients. The company's proprietary set of clinical and billing guidelines are applied at every stage of the claims lifecycle through prior authorization, auto-adjudication of claims and manual reviews. These practices detect overbilling and/or unnecessary procedures and allow Advantica to intervene in cases when services are found to be inappropriate or excessive.

"It is our goal to provide clients and members with reduced costs, improved quality of care and an overall positive experience. NCQA's renewal of our utilization management program certification is affirmation that we are achieving that goal," noted Mark Sarno, O.D., Advantica Medical Director.

NCQA's Utilization Management Certification Program assesses key aspects of utilization management operations that focus on consumer protection and improvement in service to customers. NCQA's certification review includes a rigorous on- and off-site evaluation conducted by a team of physicians and managed care experts. The NCQA Review Oversight Committee of physicians analyzes the team's findings and assigns a certification status based on an organization's performance against standards, within applicable certification options.

About Advantica – Advantica is one of the fastest growing ancillary benefit companies in the country today with more than 20 years of experience administering dental and vision benefit plans. We serve millions of members nationally through one of the largest contracted dental provider networks and thousands of independent eye care and retail optical locations. Advantica offers a variety of flexible plans designed to meet the needs of employer groups, as well as government-sponsored and commercial health plans. For more information, visit www.advanticabenefits.com. 

About NCQA – NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers. For more information, visit www.ncqa.org.

SOURCE Advantica