Your home is the result of hard work, and a sizable investment. You do everything you can to protect your haven. That includes homeowner’s insurance – a shield against unexpected storms, both literal and financial.
But what about your healthcare plan? Self-funded medical plans offer a compelling alternative to traditional fully insuranced plans, empowering you to control costs and potentially save money. However, self-funded plans are vulnerable to hidden dangers. Without proactive solutions, uncovered errors and overpayments can lead to significant financial losses on medical claims – a storm best avoided.
Your self-funded healthcare plan needs a strong defense system. That’s where comprehensive audits come in. Think of comprehensive audits as your proactive insurance policy for self-funded healthcare. They function similarly to a homeowner’s insurance policy in several ways:
- Risk Mitigation: Homeowner’s insurance protects against potential disasters, like fires or floods. Audits act preemptively, identifying and addressing errors before they lead to significant financial losses.
- Financial Protection: Both homeowner’s insurance and audits provide financial protection. Homeowner’s insurance reimburses you for covered damages, while audits recover overpayments on medical claims, protecting your healthcare budget and company bottom line.
- Peace of Mind: Knowing your home is insured offers peace of mind. Similarly, comprehensive audits provide peace of mind by ensuring the accuracy and efficiency of your healthcare spending.
Our team of experts reviews your medical claim data sets, looking for red flags in submitted claims. We protect against:
- Coding Errors: A simple typo or incorrect code can lead to significant overpayments. Audits catch these errors, ensuring employers are billed appropriately for services rendered.
- Duplicate Charges: Audits uncover these hidden costs, making sure you’re not paying twice for the same service.
- Inflated Prices: Medical bills can be complex, with hidden markups and unnecessary charges. We have reviewed hundreds of service agreements and are very familiar with reimbursement rates, fees and other valid charges. So, when we see one that is suspicious, we recognize it as a potential area for reimbursement.
Beyond Financial Protection
Self-funding offers significant flexibility and cost savings compared to fully insured plans. However, like any valuable asset, it requires protection. As an HR director or benefits manager, you are tasked with providing positive programs for your company’s employees. One of the most requested is a robust healthcare plan. Be sure you are protecting your company’s sizeable investment with annual comprehensive audits. Audits offer more than just financial protection. They provide valuable insights into potential plan design improvements. By identifying trends in overpayments, you can refine your plan to minimize future errors and maximize cost savings. We partner with you to ensure your self-funded plan remains a financial benefit, not a hidden liability.
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Contact us today for a free consultation and learn how our comprehensive audits can serve as the insurance policy against overpaying on medical claims. Heading to Chicago for SHRM 24? We would love to meet you and talk with you about your challenges. Visit us at booth #1557 to have your questions answered and to enter our raffle!
