We talk a lot about WHY you should be getting external healthcare claims audits. (These statistics emphasize the importance.) So, in this article, we are going to assume you have made the excellent decision to have audits. Congratulations! But did you know that all audits aren’t created equal? Do not assume that your self-insured healthcare … Read more
The SHRM conference in New Orleans this year was spectacular (ending the event with a Brad Paisley concert was icing on the cake!). It was wonderful talking with friends in the Human Resources world – in person – and meeting many benefits managers eager to find ways to contain costs in their employee benefits plans. … Read more
“Accountability is the glue that ties commitment to the result.” Bob Proctor Are you worried that if claims mistakes are found in your healthcare data set that you will be held responsible? We hear this a lot, but the fact is, NOT finding the mistakes and leaving them uncorrected is what makes individuals or companies … Read more
Benefits brokers are trade professionals. Just like any other profession, we count on them to provide expertise in addressing our problems. In healthcare, benefits brokers have tools that can save self-funded companies money on their health plans. General Contractors for Health Insurance Plans Think of benefits brokers as a general contractor for your self-funded health … Read more
If you’re like us, before taxes are submitted you will double-check the details several times. It’s smart to give the return one more review to make sure nothing was missed. If it’s important to review your personal finances, isn’t it equally important to review your business’s financial health? Audits Find Errors In our business, we … Read more
Companies that self-fund their healthcare plans have a fiduciary duty to ensure that those plans are being administered properly – even if that administration is done by a third-party administrator (TPA). Your company deserves the same fiscal protection from your TPA that the TPA provides to its fully insured clients. ERISA requires plan sponsors to … Read more
Each year, companies – and their employee benefits manager or health insurance broker – hold negotiations with third-party administrators (TPAs) to handle the details of self-funded healthcare plans. These agreements can directly impact a company’s bottom line. Considering the rising cost of healthcare and incidences of significant overpayments of claims, including fraudulent or abusive claims, … Read more
Don’t Let the No Surprises Act Catch You Off Guard! By now, anyone providing healthcare plans as an employee benefit should be aware of the new No Surprises Act, effective at the beginning of 2022. Whether you are the human resources manager tasked with outsourcing this important benefit or the health insurance broker providing options … Read more
It’s that time of year. Time for the annual reflections on the past year and predictions for the next. While you might think there isn’t much change when it comes to employee benefits and healthcare trends, the past two years have proven to be full of surprises. So, we’ll look at the highlights from 2021 … Read more
When you are preparing a company budget, are you including healthcare audits? Budgets and healthcare audits are both necessary pieces for fiduciary responsibility. Failure to audit could be a red flag that you haven’t protected the financial interests of your employees & employer. What’s at stake? Employers pay an average of 86% of healthcare premiums … Read more