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
“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
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
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
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