Audit Employee Benefit Claims More AccuratelyMany large employers with self-funded medical plans were driven to conduct audits primarily due to government regulations like ERISA and Sarbanes-Oxley. However, today, a 100-percent medical or Rx audit will cover every claim processed and paid. As a...Oct 30, 2024 · 2 min readtfgpartners.hashnode.dev
Powerful Software and Faster Claim AuditsThe work of medical claim auditors has evolved significantly for large corporate and nonprofit employers managing benefit plans. While random sample audits were the norm in the past, today, medical claim auditors review 100% of payments with remarkab...Oct 18, 2024 · 2 min readtfgpartners.hashnode.dev
Powerful Software Improves Claim AuditsWhen evaluating potential medical claim auditors for your company's health and pharmacy benefit plan, inquire about their technological capabilities. Many specialized firms utilize advanced, proprietary software that gives them a competitive advantag...Sep 16, 2024 · 2 min readtfgpartners.hashnode.dev
Audit Claims Before Medical Plan BudgetingWhen preparing for next year's health plan budgeting, medical claim audits are essential to consider. They provides a detailed and factual report, showing what to expect. While most claims are processed accurately, errors can occur and are costly. Wh...Aug 22, 2024 · 2 min readtfgpartners.hashnode.dev
How Medical Claim Auditors Are Unsung HeroesWhen employers self-fund their employees' medical and pharmacy benefit plans, controlling cost increases becomes a significant challenge. That's why hiring healthcare auditing companies is crucial for plan sponsors. Claim auditing is essential for re...Jul 29, 2024 · 2 min readtfgpartners.hashnode.dev
