Modern Healthcare recently reported that a new survey shows health system executives’ and physicians’ trust in health insurers has sunk to an all-time low. The annual survey measures trust based on how honest, reliable, and fair health system executives, physicians, and consumers consider health insurers.
What effect will this lack of trust have on employers who are self-insured? In job-based insurance, where more than 150 million Americans access coverage, employers do the healthcare shopping. When the employer is self-insured, the employer’s reputation becomes entangled with that of the insurer (TPA).
One way that self-insured employers can demonstrate their fiduciary responsibility to their employees is by taking advantage of a regular, comprehensive healthcare claims audit. A comprehensive audit reviews each and every healthcare claim versus a random sample audit, which only looks at randomly selected claims. Through comprehensive audits, self-insured employers can trust that they are not paying claims in error. This allows them to identify and eliminate systemic errors, which ultimately benefits the employees and overall financial health of the organization. Everyone in the system is held accountable, and it allows the employer to keep premiums reasonable while still providing their employees with quality care.
As a trusted partner in healthcare claims auditing, we make it our number one priority to protect your financial best interest. Visit Healthcare Horizons today to learn more, or contact us at hhadmin@healthcarehorizons.com to discuss how we can support the relationship between you and your TPA.