When employers self-fund medical and pharmacy benefit plans for their employees, cost increases are the most significant challenge the plans face. It's why ahealthcare claims auditis of crucial...
When a large employer, whether corporate or nonprofit, makes the wise decision to self-fund a medical plan, some responsibilities accompany the benefits. One of them is ensuring the accuracy of...
Years ago, self-funded medical plans relied on random samples when auditing claims, and there was an accepted level of accuracy that was far from perfect. But when technological advances in audit...
When large employers with self-funded medical plans negotiate their service agreements with third-party claim administrators (TPAs), there are always promises about efficiency and savings –...
A lot of financial responsibility rests on the shoulders of anyone who manages a self-funded in-house medical plan. Unexpected cost increases can affect a company's balance sheet and quarterly...
The never-ending charge of technological advances has changed and disrupted many paradigms in recent years. In the world of corporate benefits management, medical claim auditing has benefitted...
When it comes to improving the management of self-funded health plans, few who have a role to play in the process can match the importance of independent auditors. Effective medical claims reviews...
Along with technological advances in so many areas affecting businesses today, 100-percent audits of self-funded medical plan claim payments improve accuracy. Better methods for facility claims...
The relationships between the self-funded medical plans of large employers and their third-party administrators (TPAs) for claim processing can be complex. In recent years as in-house departments...
Health care costs in the United States rise every year, and the recent coronavirus pandemic added a significant new area of costs. It puts self-funded company plans under even more financial...
For self-funded medical plans, nothing is worse than incurring costs that don't benefit plan members. It's why the work of medical claims auditing firms is so essential to excellent plan...
If you're in corporate benefits management, the kind of audit you choose for your medical plan can have a significant impact. Medical claim auditing companies that use a 100-percent method –...
