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- Auditing is an Excellent Benefits Plan Management ToolOversight is one of the most effective benefit plan management tools available to employers who self-fund their programs. Improved medical claim auditing has vastly improved the accuracy of reviews and reporting. It provides an unprecedented level of oversight for plan sponsors needing to double-check their claim administrator's performance. Even when contracts have performance guarantees and...0 Commentarios 0 Acciones 2241 Views 0 Vista previa
- Claim Auditors and Medical BillingAuditing brings to mind finance and tax issues for most people, but it plays an increasingly significant role in the healthcare industry. Medical claim audits are one of the most effective tools in cost containment programs because they verify accuracy (or not). Irregularities flagged by auditors can represent significant unnecessary costs that can be recovered. Even when error rates...0 Commentarios 0 Acciones 1049 Views 0 Vista previa
- Claim Payment Oversight is EssentialIf the coronavirus pandemic did anything for health plans, it was to confirm the value of medical claims auditing. Independent oversight of medical and pharmacy claim payments is vital in verifying accuracy and flagging mistakes. No doubt, error rates are low, and many processor agreements contain provisions for self-policing. But only the watchful eye of a skilled auditor can confirm the...0 Commentarios 0 Acciones 938 Views 0 Vista previa
- The Best Oversight for Medical Claim PaymentsWhen millions of dollars are on the line annually, oversight is essential. Nowhere is it more apparent than with medical claims auditing for self-funded health plans. Pharmacy claims deserve a similar close review. Continuing improvement in electronic audit systems brings significant advances and keeps pace with changes in medical billing. It's a vast industry, and employer-funded...0 Commentarios 0 Acciones 1031 Views 0 Vista previa
- Understand More About Your Claim AuditAt first, a healthcare audit might sound complicated and it's accurate many details are involved. But if you are responsible for managing a self-funded plan and need to conduct claim processing oversight, few things are as helpful. The objective is to confirm claims are being paid correctly and mistakes are avoided, but getting to those findings takes detailed work. Each claim has...0 Commentarios 0 Acciones 1946 Views 0 Vista previa