Healthcare Claims Audit - Healthcare Horizons

Why do we need to audit claims? If you self-insure your healthcare expenses

, you will remove the direct financial incentive for the claims payer to control medical costs. It will lead to overpaying of claims that would result to additional expense in your plan. With medical expenses increasing again, employers cannot afford to continue funding additional expenses for their plans.

A company with 1,000 employees typically has the opportunity to save more than $150,000 in medical claims costs. This potential can be realized through the identification of a 2% error rate. Typical error rates for Third Party Administrators range from 2% to 5%. A 2% error would sound small until it comes out of every dollar your company spends on your employees' healthcare.

The best solution for this problem is to be able to conduct periodic reviews of your claims data. This will allow the employer and claims payer to work together so they can ensure that claims are paid as accurately as possible and that the errors made are corrected.

Healthcare Horizons team members are experienced professionals who have worked for, or with, many of the major healthcare insurers in the country. The experience with payers allows the company to conduct self-insured employer reviews much more efficiently and effectively compared to its competitors. The company reviews the entire dataset of claims rather than a sample; this allows the company to accurately target specific areas of concern to review with the payer. This also allows the company to identify the root causes of claims errors so that their clients can minimize future claim overpayments.

In addition to providing claims audit services, Healthcare Horizons also provides other services to assist large self-funded employers manage their healthcare costs such as Health benefits analysis, Pharmacy program review, Eligibility reconciliation and process improvement, RFP and contracting services, Fee schedule analysis, Utilization and network analysis, Reinsurance analysis, and Cost containment strategies.

Healthcare Claims Audit - Healthcare Horizons

By: jamiemoore1291

POST COMMENT

Examining Audi's "Quattro" technology National Engineering Conference And The Quality Of Supervision Of The 25th Anniversary Awards Right method to buy road bikes Great Discounts On Wedding Car Hires Being Offered Medical Expert Reason For $3.5 Million Settlement Of Car Accident Lawssuit The Ultimate Garage- It Can Be Yours! Hyundai's First Electric Car Unveiled Gold Step Video Broadcast System Solutions For The Campus Network Ecological Data Centre Plan. Tips And Ideas PMGE Engineering Dujiangyan Irrigation Project, An Ancient Engineering Masterpiece Used Car Market In India- A Guide Gondal Tours, Gujarat Holiday Travel Packages, Car Hire Gujarat Appoint Search Engine Optimization Professionals For Higher Traffic Rates On Your Website