800-646-9987
800-646-9987
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There’s Nothing Funny about Skipping Claims Audits

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Skipping Audits is No Joke

Chicago is known for a lot of things – hotdogs, deep-dish pizza, frustrated baseball fans and even wind. However, another aspect it’s known for is its history of comedy. With The Second City and a multitude of improv halls, it only makes sense that this year’s SHRM conference in Chi-town is featuring many well-known comedians as star-studded bonuses to the networking conference.

After you see Jay Leno or Sherri Shepherd, we invite you to stop by and see us to learn more about why skipping healthcare claims audits of your paid medical claims is no laughing matter.

Past attendees indicate that one of the reasons they attend the SHRM conference is to discover cost-saving initiatives that are important to their companies. Human resource executives are continually looking for ways to improve benefits without increasing expenses to the employer or employees. Since health insurance is consistently the most important benefit desired by employees, it’s important for HR directors and benefits consultants to find innovative and sustainable ways to keep costs manageable. A comprehensive claims audit is one tool to accomplish that goal.

Top 4 Benefits of a Comprehensive Claims Audit

Reviewing medical claims data is the only way to know for sure if your plan is administered correctly. Comprehensive audits include a review of the entire data set so that egregious errors aren’t missed (image if a random sample audit missed a 100-thousand-dollar mistake). By having annual audits, you ensure that your company is:

  • Not overpaying claims or paying claims in error
  • Identifying and eliminating systemic errors
  • Ensuring recovery of overpayments within the TPA’s timing limitations
  • Fulfilling the fiduciary responsibilities as a self-insured employer

Comprehensive claims audits have one overarching goal: to return dollars to your bottom line. You would not accept overpaying your credit card bill or allowing bank errors to go unresolved. And you would most assuredly hold someone accountable if processes were systemically in place that caused mistakes. The same is true for your self-funded medical plan. Every time you overpay for medical expenses, your plan loses money, and your employees are negatively impacted – both through the types of benefits you can continue to offer and through paying more in premiums or co-pays.

Read more: Top 10 Audit Questions

Stop the cycle! Let’s talk about your company’s needs. Call us at 800-646-9987 to schedule a meeting at the SHRM conference or visit us at booth 1557 to ask your audit questions and enter to win a unique prize!


Healthcare Horizons is a leading expert in providing healthcare claims audit services, identifying overpaid or erroneous claims through our 100% Difference model and recovering millions of dollars for clients’ bottom lines while upholding the highest ethical standards. Since 1999, the Knoxville, Tennessee-based company has provided superior healthcare claims audits for some of the world’s largest self-insured employers. We have successfully identified and facilitated the recovery of millions of dollars of overpaid claims for our customers.

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