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- TPAs and Self-Funded Medical Plan Cost ContainmentAuditing firms with medical and other benefit plan claims expertise are again in the spotlight after the coronavirus pandemic. With most self-funded plans relying on third-party administrators (TPAs), medical claims auditing is a necessary form of oversight. New testing and treatment and lengthy hospitalizations for many people added up to enormous medical costs borne by large employers via...0 Maoni 0 Shares 830 Maoni 0 ReviewsPlease log in to like, share and comment!
- The Outsized Role of TPA on Self-Funded Plan CostsLarge and mid-size corporate and nonprofit employers of many types self-fund their benefits programs, including medical and pharmacy benefit plans. But most outsource the claim processing to a third-party administrator. It means direct control of a large cash outflow is under the TPAs control and has made independent medical claims auditing essential. Because most TPAs are large...0 Maoni 0 Shares 798 Maoni 0 Reviews
- Audits Make Medical Claim Payments More AccurateThe goal of every medical plan is to pay claims accurately and with consistency according to the plan documents for covered services. But with most self-funded plans now outsourcing claim payments to third-party administrators, there needs to be oversight to make sure things go as planned. It's where medical bill auditing services come in as they review the work of TPAs to check for accuracy...0 Maoni 0 Shares 854 Maoni 0 Reviews
- Why Self-Funded Medical Plans are Auditing More OftenLarge employers, both corporate and nonprofits, have many incentives to self-fund the medical plans that cover their employees. But along with the advantages come significant responsibilities, and the financial exposure can be considerable. It's why plans today increasingly rely on their medical bill auditing services to keep tabs on claim payments. Most claims today are paid by...0 Maoni 0 Shares 813 Maoni 0 Reviews
- Claim Audits = Better Self-Funded Plan PerformanceFor many good reasons, large employers, both corporate and institutional, tend to have self-funded medical coverage for their employees. When they are well managed, the plans save money and serve employees well. It's why medical claim auditing had increasing importance because it's the tool that gives in-house plan managers an oversight ability. Today, most claim payments are outsourced to...0 Maoni 0 Shares 793 Maoni 0 Reviews
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Hadithi Zingine