Benefit Plan Claims in Need of a Review?
Keeping employee benefit plans running well is imperative for companies that self-fund them. It's the same for large nonprofit employers with similar benefit setups. Led by medical claim auditing, reviewing all benefit plan payments is imperative. Oversight is crucial because claim administrators make the payments and, therefore, have control of your company's checkbook. Outsourced processors are generally large health plans with sophisticated infrastructure. But they're set up to process claims in their own way, and your plan may have unique provisions. Auditors help you see that your rules are followed.
An opportunity exists if you've had variations in expenses and budgets outside the expected parameters and are only auditing periodically as required for compliance. When you begin to audit more often (and more thoroughly), you'll have details and explanations for the cost variances. Your outsourced claim administrator will self-report, but the independent…
