Employer Healthcare Claims Solutions

Employer Healthcare
Claims Solutions

For Employers

Healthcare Horizons™ is the partner for employer healthcare audit solutions for self-insured and fully-insured employers, bringing greater clarity to healthcare spend and delivering proactive, human-centric solutions. Our approach not only uncovers hidden inefficiencies but also equips employers with the insights needed to make data-driven decisions that enhance plan performance and employee satisfaction.

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How We Help

Financial Impact & Root-cause Correction

Our primary employer healthcare claims audit service is comprehensive auditing, identifying recoverable overpayments and preventing future losses through root-cause correction. This process enables employers to fulfill their fiduciary responsibility to audit significant expenses while directly improving their bottom line.

Plan Optimization

We help employers understand their plan details, contract language, and audit rights, providing actionable insights and identifying opportunities for future plan changes that can generate significant cost savings.

Enhanced Reporting

Robust reporting capabilities, including graphical summaries, give employers a clear, high-level view of their healthcare spend. This empowers data-driven decisions for wellness programs or refinements to plan language, such as Coordination of Benefits (COB) policies.

Long-Term Cost Reduction

By auditing and addressing rising healthcare costs—a major organizational expense—we forge trusted, long-term partnerships that reduce overall spend and help lower premiums for all employees covered by employer plans.

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Insights

9

Billion

In claims payments per year.

250

Million

In overpayments.

20

Years

Average auditing experience.

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Blog

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Mitigating Regulatory and Financial Risk Through Better Claims Oversight