Rapid Special Case Agreement Secured Under Urgent Clinical Conditions

This case involved an urgent need to secure a Single Case Agreement (SCA) for a critically ill patient transitioning from the ICU to a long-term acute care facility. With out-of-network barriers and a highly compressed timeline, Phia acted immediately to prevent delays that could compromise patient care or increase financial exposure.

 

Phia’s case handler coordinated all parties—including the provider, plan, administrator, broker, and stop-loss partners—to expedite review and agreement. The receiving facility submitted an all-inclusive per-diem proposal that Phia validated against internal benchmarks, confirming substantial savings when compared to ongoing ICU costs.

 

Although the facility’s standard agreement appeared acceptable, Phia identified missing protective provisions and worked directly with the provider to include the necessary language.

 

Despite the urgency, all signatures were secured promptly, enabling a seamless patient transfer and ensuring appropriate long-term care placement.

 

By partnering with The Phia Group, the client avoided ICU costs averaging over $10,000 per day and secured a long-term care rate of $2,600 per diem—delivering substantial financial and clinical benefits.