At Healthcare Horizons, a significant part of our workday is spent finding and recovering unexpected overpayments in our clients’ self-funded insurance plans. However, this month, rather than focusing on identifying mistakes in healthcare claims, we would like to turn our attention to recent events and the importance of those dear to us. Unexpected natural disasters … Read more
Medical claims audits aren’t scary, but the results of not performing them can be frightening! Audits are best practices in the healthcare industry, especially for self-funded health plans. Comprehensive audits involve a thorough review of claims to ensure they are accurately paid on behalf of the self-insured client. Still hesitant about conducting medical claims audits… … Read more
In today’s competitive healthcare landscape, managing costs effectively is crucial for the sustainability of healthcare benefits for an organization and its employees. The budget process, encompassing everything from forecasting to allocation, is a cornerstone of financial health. For companies self-funding their health insurance plan, this process is even more important. While the budget process might … Read more
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 … Read more
There’s a hallmark of excellence that signifies the ultimate in care and attention: white-glove service. It is more than getting the job done. It’s about exceeding expectations and creating a truly personalized experience. At Healthcare Horizons, we embody the spirit of white-glove service. We go beyond simply meeting your needs. We actively exceed expectations at … Read more
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 … Read more
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 … Read more
We know comprehensive medical claims audits are the best way to protect your company’s self-funded health insurance investment. We also know that the claims audit process can seem intimidating. But it doesn’t have to be! Here are some of the most common questions we are asked. We would love to talk with you about claims … Read more
It’s a Three-Way Tie Our 2nd annual Lost Benjamin Award voting ended in a three-way tie! The most interesting thing about the winners is that they address each of the fundamental issues we commonly see in healthcare claim errors. Systemic Errors Add Up Benefit Errors Cost More Than 7 Million Dollars – Healthcare Horizons Errors … Read more
Rising Healthcare Costs Can be Tamed In a recent blog we talked about the impact of inflation on businesses and how prudent executives are seeking ways to save money that will then help fund desired employee programs. Unfortunately, as reported in this SHRM article, rising healthcare costs are outpacing inflation. The cost of medical … Read more