1. How can DirectNet offer better negotiated rates than the large carriers?
We are industry insiders. Michael Jenike (former Hospital Administrator) and Dr. Herbert (former hospital Chief of Medical Staff) negotiate on your behalf. The Health Care Provider Marketplace has demonstrated the willingness to give the BEST rates to employers who are willing to enter into a direct, multi-year contract.

2. Is DirectNet a Third Party Administrator (TPA)?
No. DirectNet is a Custom Network. However, TPA and any other administrative services can be included in a custom Administrative Services package.

3. What TPAs do you work with?
We will work with the TPA of your choice as long as they are willing to cooperate with us in your best interest. GM&A can evaluate and recommend a TPA for you on request.

4. Can we keep our current network?
Not as you know it. We will be creating a DirectNet custom network for you. Your current provider utilization will be a factor in the creation of the new network.

5. What is the disruption?
As little as possible. We will start our process by looking at the providers that your employees are currently utilizing. Generally, when the negotiations begin, the providers who are currently receiving the highest utilization will be the most competitive. We will contact and try to negotiate with individual physician/providers at the request of any member. New physician/providers can be added at any time to your custom network.

6. How does GM&A/DirectNet get paid?
At the beginning of the process, GM&A and the client agree on a benchmark cost per member per month.
Cost Per Member Per Month =
Medical claims dollars paid out of the plan for the month ( Dr. & Medical claims ) divided by the total number of covered lives ( employee + spouse + each child )
GM&A will receive a percentage of the true reduction in cost.

7. Who manages the contracts?
DirectNet

8. Does DirectNet do credentialing?
Yes

9. How does DirectNet get our cow out of the ditch?
Please visit Our Process page for more answers.