Don’t Miss Your Negotiating Window!
Attention businesses with self-funded healthcare plans! While your team may be enjoying some well-deserved vacation time, third-party administrators (TPAs) and benefits managers are negotiating Administrative Services Only (ASO) agreements for 2025. This is a critical time to ensure your company gets the best possible deal, especially when it comes to audit rights.
Audit Rights are for Your Protection.
Self-funding healthcare plans offer cost-saving benefits, but they also come with fiscal responsibility. You’re on the hook for claims paid by the administrator to providers. Strong audit rights allow your company to verify the accuracy of those claims, potentially uncovering errors or extra fees and saving you significant money. But if you don’t have the appropriate audit rights, you could get burned and your savings washed away.
Don’t Bury Your Head in the Sand!
Many companies have no idea they should be auditing their claims data. HR executives and benefits administrators might think their broker or benefits consultant manages everything – but that’s a dangerous assumption. The responsibility for identifying and correcting errors falls on you.
During negotiations, ensure that your ASO agreement does not restrict your ability to audit the payer’s work. Here’s what you need to do:
- Review your current ASO agreement: Understand your existing audit rights and identify any limitations.
- Research industry standards: Benchmark your current agreement against what other companies are negotiating.
- Negotiate for comprehensive audit rights: Push for the ability to analyze all claims data, select targeted claims for review versus random sample selection, and review provider contracts.
Get Help Protecting Your Bottom Line!
Healthcare Horizons is here to empower businesses like yours in your audit agreement negotiations, as well as with your comprehensive healthcare plan audits. We offer a complimentary ASO audit language review and provide recommendations to help you negotiate the best audit rights. This can be a valuable starting point for ensuring that your plan isn’t overpaying for healthcare benefits!
By acting now, you can ensure your ASO agreement delivers on its cost-saving promise for 2025. Don’t miss out – negotiate for robust audit rights, protect your company’s bottom line, and take advantage of Healthcare Horizon’s free audit language review. Contact us today at www.healthcarehorizons.com or 800-646-9987.