BenefitsPro reported in May that Americans’ healthcare costs rose again by 4.5 percent, bringing them to about $28,000 per family. According to 2018 Milliman Medical Index, employers are paying more (3.5 percent), but employees are paying a lot more (5.9 percent). This trend shows a shifting of the healthcare cost burden to employees.
As self-insured employers consider how to reduce their healthcare costs, one option that many are not tapping into is the annual healthcare claims audit.
“Many employers choose to self-insure their employees’ medical expenses to save money and maintain greater plan control by having a third-party administrator manage claims processing,” said Randy King, president. “However, one of the unintended consequences of self-insuring is that claims payers have no financial incentive to control costs, which may result in the overpayment or erroneous payment of employers’ claims.”
A comprehensive annual audit, such as the 100% Difference audit offered by Healthcare Horizons, is one of the best ways to identify overpayments, errors, fraud and waste. Systemic problems and errors can be identified and corrected for future, long-term savings. The money recovered, typically 1 to 3 percent of total claims payments, is returned to the employer’s bottom line. This could, over time, lower the healthcare cost burden on both self-insured employers and their employees.
Visit Healthcare Horizons today to learn more, or contact us at hhadmin@healthcarehorizons.com to discuss a healthcare claims audit assessment.