For self-insured companies that offer vision care benefits for their employees, Healthcare Horizons can conduct comprehensive vision audits to verify and improve accuracy in payment of claims according to plan benefits.
What We Test For
Among many other factors, we look closely at:
- Eligibility
- Vision exam and hardware coding accuracy
- Benefit maximums
- Patient responsibility (deductibles, coinsurance, copays)
- Pricing
- Duplicate payments
- Coordination of benefits
The Audit Report
Once we have completed our review, we deliver a final report to the client revealing the areas we tested and our findings, an accounting of all erroneous claims detected, and an explanation of any root-cause issues that were identified, along with recommendations for correction.
To learn more, contact us.