There are essential differences among medical benefits plan auditors, and the cost is one of them. Today’s best audits review 100-percent of medical claims – and often claims for each of a company’s employee benefits plans – and do so in a budget-neutral manner. Full-service auditors go several steps farther as they provide analysis of the results and suggestions for claims administration improvements. It means client companies reap financial benefits in future years because of better plan performance. Also, benefits recipients (the company’s employees) are better served over time.
Complete plan audits covering 100-percent of medical claims have a more significant change for budget neutrality because they catch and correct more errors. They also yield more accurate data for analysis that can lead to unmatched improvements in claims administration performance. Human resources and finance professionals are often surprised at the improved results delivered by complete plan audits if they have been familiar with less advanced random sample methods. With a greater need than ever to manage rapidly rising medical expenses, companies need better functioning claims administration.
Saving time internally also supports a company’s decision to implement a complete claims audit. They are a must for self-insured plans and help meet specific regulatory requirements. Because the recommendations for improvements based on accurate data are long-lasting, most mid and large-size employers can see considerable cost savings. It supports the decision to choose a claims auditing firm with a 100-percent method. Those who have the most effective technology and experienced auditors can produce accurate results clearly and efficiently – less time for a better outcome.
The most effective benefits plan claims auditing firms perform a natural management consulting function as they make future recommendations. It supports their budget-neutral work and adds value in many ways. The goal always should be to plan performance that serves employees well while managing costs thoroughly. Outside claims administrators also benefit from process improvement suggestions as their systems are improved and run more effectively. No random-sample method can match the effectiveness of a 100-percent claims audit. They make sense on many levels.