Learn more about us.
Get answers to the questions we get asked the most.
Is SentryHealth a health plan?
No. SentryHealth is not a health plan nor insurance provider. We do not replace a health plan or health insurance coverage.
What types of organizations do you work with?
We primarily work with mid-market, self-insured organizations across the United States.
How long have you been in business?
SentryHealth was founded in 2011. In 2021, we merged with MAP Health, a provider of medical advocacy services since 2001. In 2022, we merged with Wellview, a virtual care company in business since 2013.
How does SentryHealth work with an existing health plan?
We enhance health plans by layering in additional capabilities to connect members to high-value care. We can also fill in gaps in health plans with our virtual care team.
How does your care navigation work?
With advanced data science, we develop Personalized Care Profiles. Then, our Registered Nurse Advocates use their clinical expertise to guide each person to programs, services, and resources that will have the greatest impact on their overall health.
We understand that no two people are the same. So we don’t take a cookie-cutter approach to healthcare navigation. We make sure people get connected to the most cost-effective, high-quality care they need when they need it.
What is your clinical model?
We believe in a proactive, integrated approach to care. When members need assistance, our Nurse Advocates are there from the very beginning. Coordinating with our Medical Director and care team, they assist members in getting the right diagnosis and finding the highest-quality providers as well as coordinating treatment and follow-up care to ensure the best clinical outcomes while avoiding unnecessary costs.
What criteria do you use to identify best-in-class providers?
SentryHealth turns an average provider network into a high-performing network. We use proprietary data intelligence to identify the very best providers in any network. We consider things like market area, procedure volume, quality of care provided and clinical outcomes, costs, experience, certifications, readmission rates, and more.
What makes SentryHealth different from your competitors?
We take a clinical-first approach to care navigation, ensuring that members have a Nurse Advocate in their corner from the very beginning. Using advanced data and behavior science, we guide members to the right care at the right time, preventing and addressing high-cost events and conditions.
Can you integrate with other vendors?
Yes! We are integration-friendly with the ability to connect to an employer’s preferred vendors while enhancing the member experience. By connecting the member experience across all health benefits, we maximize engagement, simplify vendor management, and increase value for employers.
What is your pricing model?
While the greatest cost-savings and outcomes come from our fully integrated advocacy and virtual care services, we offer flexibility in design and payment structure. We offer flat rate PEPM pricing, per encounter pricing, and can even bill services as claims.
How do you work with benefits advisors, brokers, and consultants?
Partnering with a proven leader like SentryHealth offers advisors a distinguished competitive advantage. Our solutions are integration-friendly and configurable, backed by experienced data scientists, clinical experts, engagement specialists, and client service professionals. We provide advisors flexibility and key insights while alleviating headaches and increasing value.
How do you partner with TPAs?
We assist members with steerage to quality, cost-effective providers and also act as a coordinator between the member and TPA to assist with any issues that may arise
Additionally, we coordinate between the TPA and reinsurance carrier to assist with identifying high-dollar claimants and providing a summary of expected ongoing costs to set appropriate group rates.