There are plenty of things to make us go “hmmm,” but health insurance payments shouldn’t be one of them! Our job, every day, is to identify mistakes in healthcare claims payments and occasionally we run across a case where there just doesn’t seem to be a logical explanation for an overpayment. In 99% of these … Read more
There is no GOOD hidden fee in your self-funded healthcare plan. We’re all familiar with hidden fees or undisclosed costs. We see the “extra charges” once we’re ready to check out on Ticketmaster, VRBO or any major airline, to name a few. These charges are so common that they really aren’t “hidden” anymore. We know … Read more
It is important that human resources leadership and corporate counsels be mindful of the growing efforts by disgruntled employees and employee advocacy groups to utilize ERISA regulations to initiate class-action lawsuits related to alleged failures to appropriately manage medical costs. Motivated by the escalating impact on employees and their families from annual increases in health … Read more
It’s fun to search for four-leaf clovers in the hopes of finding unexpected luck. But if you rely on wishes and leprechauns to keep self-funded healthcare expenses in check, your luck is going to run out. Each year businesses lose millions of dollars from incorrectly paid medical claims. Even the best benefits administrators don’t always … Read more
February is Heart Health Awareness month, but heart care should be a focus every month! Heart disease is the leading cause of death in America according to the Centers for Disease Control. Its impact is costly to all Americans and businesses and deserves appropriate funding. Some quick facts: Heart disease is the leading cause of death for … 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
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
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