Integrated Solutions
No two workforces use benefits the same way. To meet our clients’ unique needs, we combine a high-touch service model with the flexible plan-designs that focus on workforce, goals and preferred partners.
Benefits how you need them
A benefits strategy should fit the workforce it serves, not force every employer into the same model. We work closely with employers and benefits consultants to bring plan design, network strategy, vendor integrations, cost-containment tools, and member support into one coordinated experience.
At the center is HealthView: a secure, mobile-friendly portal where members can find plan details, view claims, access ID cards, complete forms, and connect to the right support. Behind the scenes, we help keep the strategy aligned through implementation, renewals, reporting, and the moments when members need help most.
OUR PRODUCTS, TECHNOLOGIES, & METHODS
A more connected way to manage care
HealthView member portal
A secure, mobile-friendly front door for benefits helps members find plan details, view claims, access ID cards, complete forms, and get support without digging through disconnected systems.
Integrated advocacy model
A connected support model that brings clinical guidance, cost strategy, and member advocacy together, helping people find quality care at a lower cost while giving employers a clearer path to stronger ROI.
Care navigation and concierge service
Healthcare can feel like a maze, so we give members clearer guidance on where to go, what to do next, and how to use their benefits with more confidence.
Cost containment solutions
We look for the savings opportunities hiding in plain sight, from medical bill review to out-of-network negotiation and subrogation, helping plans reduce avoidable spend without leaving members to sort through the mess.
Robust network partnerships
Every workforce has a different care map, so we work with national, regional, and specialty network partners to help employers balance access, flexibility, and cost in a way that fits their people.
Integration partners
The right partners can make a plan stronger, but only when they work together. We connect trusted partner solutions into one coordinated strategy, helping employers add flexibility without creating more confusion for the people using the plan.
Start with HealthView
When benefits feel scattered, people need one place to begin. HealthView gives members a secure, mobile-friendly front door to their plan, with access to claims, ID cards, forms, plan details, and support resources in one place.
Benefits access anytime
Members can view plan details, coverage information, and claims history whenever they need it.
Claims and EOB transparency
Claims status and Explanation of Benefits details are easier to find, track, and understand.
ID cards made easier
Members can order replacement cards or generate temporary ID cards without waiting for extra support.
Provider search and comparison
In-network provider search helps members compare care options and make more informed decisions.
Real-time benefits support
During business hours, members can connect with our benefits assistance team through chat for help with questions and next steps.
Secure on any device
A mobile-friendly experience helps members access their benefits with confidence, wherever they are.
Pinnacle Advocacy brings the pieces together
Point solutions only work when they fit the plan, the population, and the way members actually use their benefits. Pinnacle Advocacy connects clinical guidance, cost strategy, partner solutions, and member support into one coordinated model — helping employers move beyond disconnected vendors and toward a benefits experience built to perform.
With HealthView as the front door and our team guiding the experience behind it, members know where to go, employers gain a clearer strategy, and benefits consultants have a partner ready to help make the right solutions work together.
A clearer path through healthcare
HealthView gives members a place to start. Our healthcare concierge support helps them take the next step: finding care, understanding options, resolving issues, and using their benefits with more confidence.
It’s a hands-on layer of support designed to improve the member experience and reduce administrative burden for employers.
Dedicated health guide
Members connect with the same expert every time.
Early access
Available via app, chat, or phone whenever needed.
Simplified healthcare navigation
Find in-network doctors and book appointments with ease.
Billing assistance
Get help understanding and managing medical bills.
Smarter decisions
Expert guidance leads to better healthcare choices and cost savings
Cost transparency
Know out-of-pocket costs before appointments
Healthcare concierge
that helps members take the next step
Deliver smarter savings without compromising care
Cost containment should do more than trim expenses. It should help employers protect plan dollars, preserve care quality, and make smarter decisions about where healthcare spend is going. Our strategies are built for self-funded plans of all sizes, with hands-on review, negotiation, and recovery processes designed to deliver measurable results.
64%
average recovery rate over the past 3 fiscal years
Helping protect plan assets when another party is responsible.
Medical bill review
We review medical bills line by line for accuracy, appropriateness, upcoding, unbundling, and DRG validation — with clinical oversight by nurses and physicians for high-dollar claims.
Out-of-network negotiation
We actively negotiate out-of-network claims to reduce avoidable plan spend, achieving an average 68% savings on out-of-network claims — approximately 137.5% of Medicare on a national basis.
Subrogation & lien recovery
When another party may be responsible for an injury or loss, we help protect plan assets through lien establishment, liability review, settlement negotiation, and ongoing communication with members, providers, attorneys, and insurance carriers.
Small-claim protection
For out-of-network claims under $5,000 (representing 96% of all out-of-network claims) Pinnacle assumes financial responsibility, helping reduce exposure and simplify the process for the plan.
Find the right network strategy for your people
Every workforce has different access needs. That’s why we help employers and benefits consultants connect proprietary networks, clinic options, and trusted network partners into a coordinated plan strategy — balancing access, flexibility, and cost control.
Integration partners, without the point-solution maze
The right partners can make a plan stronger when they’re connected with purpose. We bring partner solutions into a clearer, more coordinated experience, helping employers and benefits consultants reduce complexity while giving members a better way to find the support they need.
Member Advocacy
Give members a clearer path to care, cost guidance, provider search, and benefits navigation with tools that help them make smarter decisions and know where to go next.
PBM Partners
Build a pharmacy strategy around transparency, flexibility, and plan performance with partner options that help support smarter spend and a better member experience.
Stop Loss/Captive Partners
Support self-funded plans with risk strategies designed to protect against volatility, strengthen predictability, and keep long-term plan goals within reach.
Other Partners & Point Solutions
Bring specialized solutions into the plan experience without creating a maze for members — so the right support is easier to find, access, and use.
OUR PROCESS FOR integrated SOLUTIONS
A flexible system
Finding the right fit between plan design, benefits, and support systems is a delicate balance, but it’s our main priority when it comes to delivering tailored solutions that make our clients’ lives easier.
OUR APPROACH TO integrated SOLUTIONS
A grounded, realistic mindset
Our approach to Integrated Solutions is built around turning benefits strategy into a real, usable experience for employers and members.
Execution-led tailoring
Change is operationalized so employers feel the difference, instead of getting stuck in “promise vs. reality.”
Service-first model
We bring a high-touch focus, built on responsive teams and a willingness to customize to meet client needs.
Coordinated ecosystem
Our integrated approach reduces member confusion from too many vendors, apps, and portals.
Member comprehension & adoption
On-site support and simple communications (posters, flyers, break-room materials) helps members actually use benefits.
Bilingual, bicultural support
Culturally competent, tailored communications and service improves access and understanding for diverse workforces.
Navigation & advocacy
Built-in care navigation support helps members who are unfamiliar with the healthcare system find the right help faster.
Let’s make a better health benefits experience
When it comes to tailoring our services to your needs, we’re always happy to talk. Fill out our contact form and we can talk about your unique needs, and how our services can meet them.
