 Over the last 18 months you have spent anywhere from hundreds of thousands to millions of dollars on health care cost. For most of our clients, questions arise from time to time about how their health plan's claims have been paid. Sure you have people who check your claims, staff personnel, your insurance providers, TPAs, even your accountants. All of the big 6 auditing firms even examine them. The TPA who is carefully paying your claims, checks and double checks these items for accuracy. However, even the best run health plans have some degree of claim payment error. These errors can quickly add up to 2% to 5% or more of paid claims. For every 100 employees that is about $7000 to $17,000.
If you knew of claims that should not have been paid by your plan, how would you go about getting the money back?
If you could get back 2% or more of the claims paid by your health plan in the last year, would it be worth a day or less of your time over the next three months?
Unlike most companies that conduct sample audits. At Patterson Bryant we conduct a thorough statistical audit, whereby we examine 100% of your claims and pinpoint specific claims that should be refunded to your plan. Few companies are able or willing to analyze this data in-depth like we do. More importantly, when we find recoverable dollars in any amount WE pursue them on your behalf. Imagine for a moment if the IRS audited EVERY tax return. Do you think they would find a few more errors or even worse, fraud? Sure they would, and so do we!
If you assume that all of your claims are being paid accurately or that you already have someone doing this process it may well be costing you millions of dollars. Our process uses 31 modules grouped into 3 areas. Claim Recovery, Data Enhancement Services and Membership Compliance Surveys.
This entire process takes a combine time-frame of 90 Days from start to finish. Your company involvement will take no more than 8 hours. The 8 hours includes initial evaluation, phone consultations and final presentation.
To control benefit costs you must control claims which are 75% or more of those costs. Contact us today and find out why the largest insurance carriers in the country utilize our services for their major clients. |
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