Claim and Operational Audits to Help Control Health Care Costs
The rapid growth of health care costs continues to challenge human resource and finance professionals. Continuing to offer competitive benefits at affordable rates, while complying with employer mandates, regulations, and administrative rules, is becoming increasingly difficult. Claim audits can be an effective way to ensure that organizations’ (and their employees’) benefit dollars are being spent only as dictated by plan rules, and that their plans are operating efficiently. Claims audits can also be an important first step towards containing the growth of health care costs, and should be included as part of an overall benefits strategy. Employee benefit health plan claims audits can also help satisfy supplementary financial disclosure requirements and play an important role in discharging trustees’ fiduciary obligations.
This Webinar will address how Employers can gain confidence that:
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Their customized plan designs are truly being administered as written. (e.g., coverages, limits, exclusions, contribution strategies, etc.)
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Medical necessity is documented in all cases - especially for popular, expensive procedures
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Health benefits are provided only to eligible employees and their valid dependents.
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Stop Loss policies are integrated and recoveries are maximized.
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Subrogation and Other Party Liability are being administered correctly for maximum recoveries.
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Agreed on Administrator performance measures are being met.
Our co-presenter for this webinar, BMI Audit Services, specializes exclusively in testing and analyzing health benefit plan claims to support corrective actions and overpayment recoveries. BMI has tested over $25 billion in health care claims since its founding in 1998 and reviews more than 100 plans annually.
The Webinar was held on March 25, 2008 and March 28, 2008
Click here to view the presentation
If you have any questions, please call (617) 351-6000.