Your company needs to be conducting annual healthcare claims audits. YES, you are entitled to claims audits! Healthcare claims are one of the biggest expenses for companies that self-fund their employee healthcare plans. How do you ensure you are not overspending on claims? Employer Healthcare Costs are Rising Healthcare costs, to no one’s surprise, have … Read more
Healthcare audits are the best way to ensure cost containment of health insurance plans. But we know that the last thing you want to do as a human resource manager or insurance broker – especially after open enrollment – is deal with the details of healthcare audits. Good news! We do the work so you … Read more
Providing Value-Add to Clients Claim audit service is an extra benefit for brokers to present to clients. Audit services can save clients big money over time. There are 4 significant advantages to brokers who include a claim audit service in their proposed recommendations. Healthcare is the largest expense for self-insured employers. They should feel confident … Read more
*This article has been updated to include new information.* Helping Human Resource Leaders become Healthcare Heroes! At the upcoming Society of Human Resource Management (SHRM) conference, Healthcare Horizons will meet with hundreds of individuals tasked with ensuring that a company’s health insurance benefit is a viable option for their employees, without sacrificing coverage to reduce … Read more
The BenefitsPro article, Employees as Assets, the C-suite as Investors, discusses the trend in recent years of CFOs and other members of the C-suite becoming more involved in the decision-making strategy of employee benefits. As the C-suite begins to see employees as assets, they also start to view benefits as investments. When the C-suite is … Read more
Many people often put off filing tax returns until the last minute. They have that nagging anxiety of not knowing – did I overpay and I can look forward to a refund or did I underpay and how much will I owe the IRS? Self-insured employers may approach healthcare claims audits in a similar way, … Read more
Last month, we examined a few of the top categories of claims payment errors. Because every healthcare claims data set has errors — people make mistakes — it is important for self-insured employers to perform an independent, fully comprehensive audit annually to identify errors, correct systemic issues for future savings and recover claims that were … Read more
In this two-part series, we will examine a few of the top categories of claims payment errors. Missing these common errors means that self-insured employers are leaving possibly hundreds of thousands of dollars on the table every year.Rather than asking your employees to contribute more in terms of higher premiums or reducing their benefits, self-insured … Read more
The current practice of “balance billing” allows health care providers to charge the insured employee for the balance of a medical bill when an insurance company does not pay the full amount. Surprise bills can be the result of an insured unknowingly receiving medical services from an out of network provider. These unexpected bills can … Read more
Oftentimes we believe that if we pay more for something, we can expect to receive a product of higher quality or features. While that is sometimes true, in many instances you may just be paying for a name. When it comes to healthcare claims auditing, looking for the most familiar name does not ensure that … Read more