Last week, the eyes of the nation were trained on the so-called “Super Tuesday States,” as voters took to polling places for the presidential race. Our news cycles have been dominated not only by the results, but also by the polling leading up to Election Day.
There have been moments during the past few months when reporters and media outlets were surprised by the outcomes, particularly when compared to pre-election polling. The random sample polls do not always reflect an accurate picture of actual voter sentiment.
In our business, I can see a similarity in the importance of conducting a comprehensive healthcare claims audit. Many companies who self-insure believe they have solid plan designs, and they do not conduct audits due to their strong working relationships with their third-party administrators (TPAs).
However, most of our clients are surprised at how often errors occur, and how quickly those claims paid in error can add up to a significant financial impact on the plan. Once we identify systemic and repeated claims paid in error, our clients have a heightened understanding of the importance of a comprehensive claims audit versus a random sample audit or not auditing at all; and they make it part of their standard operating procedure.
In utilizing our proprietary algorithms to highlight systemic mistakes, clients are able to correct root causes for future claims. As an added bonus, we help to recover those prior claims paid in error, returning value to the bottom line. If you would like more information about a comprehensive claims audit or our unique process, please contact us.
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