Medical claims payments have become so complex that even the most advanced claims administrators face challenges paying claims correctly. According to a recent insurer report card, claims payment accuracy of national insurance companies ranged from 62% to 87%. Even the most advanced electronic medical claims processing system is no guarantee that your healthcare benefit claims are paid accurately.
Each year billions of dollars are wasted on incorrectly paid healthcare benefit claims. Benefit plan overpayments are estimated to exceed $80 billion per year. Medicare reported overpayments of $12 billion or 6.3% per year in total expenditures.
We can help your company find these savings. We typically detect between 2-7% in unnecessary expenses, which includes recoverable overpayments.
Our approach to claims payment verification reduces expenses, improves cash flow and identifies correctable patterns of errors. This ensures that your health benefit plan is operating at maximum efficiency. Escalating healthcare costs make it critical that all self-funded plans are regularly reviewed for accuracy and effectiveness.
For more information about Data Analytical Audits, please contact us!