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guidedconcierge.com

Everyone

deserves a

Guide

+Proactive outreach

+Real Guides

+Smart technology

+Every benefit

+Results you can see

All paths, guided.

Built with intention, by healthcare industry leaders

Guided Health Concierge is the product of careers spent building and running national member advocacy programs. Our founders took what they learned and designed something more deliberate from the ground up.

Experience first. Nearly a decade of building advocacy shaped every decision we made.

Designed, not assembled. Each piece was built to close a gap we saw firsthand.

Built for today. Proactive, data-informed support for every benefit.

CRO

Angela Marchak

Chief Revenue Officer

Over 20 years building revenue and broker partnerships across benefits and healthcare navigation.

Codi Gill

Chief Client Officer

Over 20 years of benefits experience, with 15 years building and scaling industry leading service organizations within the HR and benefits space.

CCO

COO

Juliet Frerking

Chief Operating Officer

A decade leading operations and technology across healthcare navigation, compliance, and client experience.

All the plan options, none of the answers

Employees are handed plans, programs, and point solutions, then left to figure them out alone.

They don’t know what they don’t know.

Even engaged employees don’t know what to ask their doctor or insurer, so benefits go unused and better options go unseen.

Healthcare is shoppable, but hard to shop.

Price, quality, and coverage vary by provider. Comparing them takes expertise and patience most people don’t have.

84%

struggle to navigate their benefits

1 in 3

skip care due to cost

98M

prescriptions abandoned

~1 in 2

referrals never completed

Sources: KFF Health Tracking Poll, March 2026; American Heart Association, 2026 Voice of the Employee Survey; IQVIA, 2024; Becker’s Hospital Review, 2026.

Barriers block great benefits

Barriers to care include the hassle of getting it and the realities of everyday life. Both are hard to overcome alone. Social determinants of health include:

TransportationCostLanguageHealth LiteracyTime off work

Every step is a hurdle

Every step means calls, forms, and waiting. Many people give up on care entirely.

Life gets in the way

Rides, time off, childcare, and cost can put even simple care out of reach.

Julie needs a new doctor.How care gets abandoned, one step at a time.

Searches her carrier’s website, then calls each office one by one

Waits on hold, then waits for a call back

They’re out of network, not taking new patients, or booked for weeks

She gives up. No new doctor, no appointment, and no care.

From a $0 screening to a $250K claim.

Julie’s missed preventive visit became a late diagnosis that was harder to treat and far more expensive.

We saw the gaps. So, we built the solution.

Every gap we saw in traditional navigation became a design requirement.

Traditional navigation

Waits to be called

Reacts without health data

Expects members to know what to ask

Health insurance only

Value that’s hard to prove

Reaches out first

Sees what’s coming in health data and steps in early

Guides members to the questions they didn’t know to ask

Every benefit and point solution, not just medical

Reporting that shows what changed

Proactive when it matters. Ready when needed.

Julie’s year with Guided Health

Month

Welcome to Guided Health

We reached out

Julie gets a welcome message when her employer launches Guided Health. A quick questionnaire helps us learn her health needs.

Month

Finding a therapist

Julie reached out

Julie wants to start therapy. Her Guide checks her benefits, finds an in-network therapist with openings, and books her first session.

Month

A new specialty prescription

We reached out

Julie starts a specialty medication. We reach out proactively with lower-cost alternatives available to her.

Month

A surprise bill

Julie reached out

A bill arrives after a preventive visit. Her Billing Guide works with the provider and insurer to bring it to $0.

Month

A growing family

Outreach and follow-up

When a prenatal visit shows up in her claims, a Guide checks in with support. Julie calls back to explore in-network, lower-cost care options.

One year with Guides. Two types of savings

Julie’s year with Guided Health

For Julie

$6,140

less out of pocket, and one bill she never had to fight.

For the plan

$24,500

in claims avoided, from one member, in one year.

Monthly momentsJulie savedPlan avoidedStarted by

1Welcome + preventive visit booked$0 visitEarly risk flagWe reached out

3In-network therapist booked$1,200$1,500Julie reached out

5Lower-cost specialty Rx alternative$1,800$14,000We reached out

8Billing error corrected to $0$6400 escalationsJulie reached out

11Prenatal care steered in-network$2,500$9,000Outreach + follow-up

3 of 5 savings moments started with us, not Julie. Without proactive outreach, most of the plan’s savings never happen.

Figures are illustrative for one plan member, over one year with Guided Health

Every benefit & point solution, finally connected

Employers invest in programs and point solutions that members never find. We become the one place members start, and we connect them to the right program at the right time.

On their own

With Guided Health

Medical

Pharmacy

Dental and vision

Voluntary benefits

Medicare

Billing

Point solutions

●One place to start

Any question, any benefit, one team.

●Point solutions that get used

We connect members to programs they already have.

●A team that knows the plan

Medical, pharmacy, dental, vision, Medicare, and billing.

●Fewer handoffs

No dead ends, transfers, or repeat explanations.

One team for every benefit and every need.

Everyday benefits

Clear answers on coverage and cost, plus decision support to choose the right plan at open enrollment

Prescriptions

Specialty medication support and lower-cost alternatives

Bills, denials, and approvals

Errors caught, denials appealed, approvals sorted

The right care

Quality providers with upfront price transparency, and care that stays coordinated

Life moments

Support through big moments, like a new diagnosis or a critical medical decision

Proactive support

We reach out before members need to ask, using census milestones and health data signals

For members

A Guide for every health question
Easy-to-use app and portal
Plan docs and resources in one place
Proactive outreach tied to their health profile
Access via phone, portal, app, or email

For HR

Intuitive admin portal
Health dashboards
Quick implementation
Easy document uploads
Easy TPA onboarding integrations
Regular performance reports

Easy to reach.
Easy to roll out.

Members can reach their Guide team however they prefer.

Call: talk to a real person on the Guide team

App/Portal: message the Guide team from the member portal

Email: send a question and get a clear next step

Every request gets a real Guide.

Members have a dedicated team that knows their full benefits package and reaches out proactively with screening reminders, medication options, and missed benefits, all aligned with their health goals.

Two sources. One goal.
Reach members before they ask.

Census data tells us who your members are and where they are in life. Health data tells us what’s happening in their care. Together, they tell our Guides when to reach out, and where cost is building.

Census data|Who they are.

What we receive:
Your employee and dependent roster, with ages, gender, hire dates, and plan coverage, kept current with eligibility updates.

How we use it:

Health profile during onboarding
Preventive reminders by age and gender
Life moments, like turning 26 or 65
Welcome outreach for new members
Birthday checklists and enrollment reminders

Health data|What’s happening in their care.

SourceWhat it tells usHow we use it

Diagnosis dataA new diagnosis, a chronic condition, or a gap in follow-up careWe connect members to specialists, programs, and centers of excellence early

Pharmacy (PBM) dataNew or specialty prescriptions, lower-cost optionsWe share cost-efficient alternatives and help members stay on track

PrecertificationsSurgeries, procedures, and admissions before they happenWe confirm coverage, share a cost estimate, and point to quality, fair-priced facilities

It starts at intake, before the first claim

What the member app asks at sign-up, and what each answer sets in motion

The app asksWhat it triggers

Do you have a primary care doctor? When did you last see them?No PCP, or 2+ years since a visit: we find an in-network PCP and book the annual checkup.Fewer claims

Screenings by age and sex: mammogram, colon, well-woman, bone densityGuides schedule what’s due. Preventive visits are usually covered at no cost.Fewer claims

Any ongoing conditions? Diabetes, blood pressure, heart, COPD, cancer, back or joint painClinical team review, then the right condition program or point solution.Fewer claims

Which medications do you take? Do any feel expensive?Lower-cost alternatives; specialty drugs and GLP-1s go into programs.Smaller claims

Is anything making it hard to get care? Transportation, cost, time off, childcare, languageRides, video visits, evening hours, interpreters, so care isn’t skipped.Fewer claims

Any medical bills you’re unsure about?A Billing Guide reviews and negotiates.Member saves

>30%

of U.S. adults had no usual source of care in 2022, the highest in a decade

2025 Primary Care Scorecard

A concierge, not care management

Every answer is optional and only the Guide team sees it, never the employer. Guides own the conversation; our clinical team works behind the scenes.

Source: Robert Graham Center and Milbank Memorial Fund, The Cost of Neglect: 2025 Primary Care Scorecard. Intake questions from the Guided Health member app.

From your data to the first outreach.

1Data in

Your census and health data come to us securely.

2Triggers set

Life stages, milestones, and changes in care each become a reason to reach out.

3Outreach scheduled

Personal outreach by phone, portal, or email, aligned with HR preferences.

4We follow up

We confirm members followed through with the recommended care.

Why it works: behaviors shift, preventive care goes up, members use the benefits they already have, and high-cost claims are caught early.

MOMENTS WE ACT ON

26Aging off a parent's plan

A new specialty prescription

40Annual mammograms start

A new diagnosis

65Approaching Medicare eligibility

Data Impact & Scenarios

70-80%

large claims tie back to a handful of conditions

CancerOrtho/MSKHigh-risk pregnancyDiabetes and obesity

Tools built on national clinical care standards help Guides drive patient adherence, intervene early, and connect members to second opinions and clinical trials.

The goal: fewer large claims, and smaller ones when they happen.

Cancer

78 claims · $65.8M · about $843K each

Fewer claims Biomarker testing and a second opinion at diagnosis

Smaller claims Clinical trial search, right site of service, claim review

~1 in 3

advanced cancer patients gets biomarker testing for targeted options

JAMA Netw Open, 26,311 patients

Ortho/MSK

#3 in Sun Life’s book · avg. claim $116.4K

Fewer claims Guides call at precert; second opinion before surgery

Smaller claims Center of excellence bundled price; PT and bill review

54%

of Walmart spine patients at a center of excellence avoided surgery

Walmart COE program, 2015–2018

High-risk pregnancy

47 claims · $64.3M · about $1.37M each

Fewer claims Risk flagged early; delivery where the right NICU is on site

Smaller claims NICU billing review

4 → 8

NICU levels some providers bill, up from the standard four

RGA, 2023

Diabetes and obesity

GLP-1 high-dollar claims up 24% in a year

Fewer claims Partner program built around comorbidities

Smaller claims Prior auth, lowest-cost channel, results check

31.5%

of adults on a GLP-1 for obesity were still on it at one year

Prime Therapeutics, 5,780 adults

Sources: Amynta ESL claims >$450K, 2017–Aug 2026 (internal); Sun Life, High-cost Claim and Injectable Drug Trends Analysis, 2025 and 2026 eds.; JAMA Network Open via ONS, 2025; Walmart via Becker’s, 2019; RGA, Protecting the Tiniest Patients, 2023; Prime Therapeutics, AMCP Nexus 2025.

Where care happens decides who pays

Cumulative claim cost, one member, first 12 months ($K)

Illustrative example · hypothetical member and inputs

Infusions at hospital ratesRedirected from month 2Specific deductible ($250K)

Infusions at hospital rates

$420K

total cost for the year

$170K

reimbursed above the deductible

Redirected from month 2

$306K

total cost for the year

$56K

reimbursed above the deductible

$114K

less reimbursed by the carrier. The employer pays its $250K either way, so the savings land above the deductible.

Illustrative: $35K/month at hospital rates, alternative site priced at hospital ÷ 1.42, $250K specific deductible. Cost difference from a matched cohort of 52,760 infusions (2022–2023) showing ~42% higher costs in hospital outpatient departments.

Add-on services

Build the support package your clients need

Digital Health

Care by phone or video, from a dedicated primary care team for everyday needs to therapy and urgent visits

Includes: Teletherapy · Telehealth · Virtual Primary Care (VPC)

Year-Round Enrollment Guidance

One-on-one decision support to choose the right plan, with communications that keep members informed all year

Includes: Benefits Selection Consultations · Communications · Notifications

Clinical Second Opinions

An expert second look at a diagnosis or treatment plan from a network of world-class doctors, so members get clear direction and can take their next step with confidence

Specialty Care Management

The right place and price for specialty treatments and medications, with support to stay on track

Includes: Infusion support · Specialty prescription support and management

Real outcomes: Proof, not promises.

What we did

Engagement

members reached and outreach completed

Proactive engagement

cases we started vs. cases members started

Types of cases opened

where members needed help

Service performance

how we did against our commitments

Member satisfaction

satisfaction and NPS at case close

What changed

Behavior change

preventive care completed and better choices made

Care patterns

ER vs. urgent and primary care, and in-network vs. out-of-network care

Pharmacy

generic and lower-cost alternative adoption, and refill adherence

Cost trends

total and per-member spend, high-cost claimants, and specialty drug spend, year over year

Partnership Review dashboardSAMPLE DATA

Outreach funnel

Flagged

1,200

Reached

940

Engaged

610

Care completed

430

Preventive screenings

68%

Physicals

+9 pts YoY

61%

Mammograms

+11 pts YoY

54%

Colorectal

+7 pts YoY

Specialty Rx savings opportunities

Specialty Rx flagged

Reviewed with a Guide

Switched to lower-cost

86%

generic and lower-cost alternative adoption

NPS at case close

< 1 hr

Avg. first response

98%

SLAs met this quarter

Talk with our team about what your clients and their employees need.

Questions about healthcare & benefits?

We know a Guide.

Let’s work together

Getting started

1Meet your account manager
2Build an outreach plan around your census and health data
3Go live, usually within 30 days

Contact

Angela Marchak, Chief Revenue Officer

Phone

732.266.9211

angela.marchak@amyntagroup.com

Website

guidedconcierge.com