For anyone managing an employer-funded health plan, imagining a more challenging moment than the coronavirus pandemic is difficult. It's stretched resources beyond their limits and left some things changed forever. In the aftermath, medical claim audits have helped review and confirm the experience. Their data and reports feed the planning and management process. The big question could we have done anything better to get through the situation more smoothly? It also points out the value of a continuous monitoring service. If claims were monitored in real-time, you knew more.
Data and details are everything in health plan claim administration. Because thousands of claims are paid individually, there is an almost infinite opportunity for errors. On the flip side, the accuracy with which outside claim processors work is impressive, yet the few mistakes they make are costly. When you audit your plan continuously, the real-time data is invaluable. There's no better way to stay on top of things and manage actively. Your processor will likely find systemic errors that occur in large, repeating patterns. But your auditor can find individual ones that are equally worth correcting.
All of the improvement in claim auditing has been driven by a few cutting-edge firms that have developed unique systems and methods. Their command of electronic review design has quietly revolutionized the industry over the past few years. A level of detail and accuracy that was once unimaginable is now familiar today. It informs providers and processors that plan managers are well-spent and have options to provide meaningful oversight. The knowledge keeps them on their toes and assures you of optimal performance. You'll see a consistent performance improvement.
Schedule one today if your post-pandemic review still needs to include an audit. Regardless of the data you have in hand already, having something to compare it against is insightful. It would be possible but highly unusual for an auditor to find nothing of benefit to you. Even plans with ultra-low claim processing error rates can benefit from auditing. Tightening up irregularities and understanding them to prevent future ones is good management. When auditors are double-checking and reporting their findings, you have an independent analysis of plan performance that you can trust.
Data and details are everything in health plan claim administration. Because thousands of claims are paid individually, there is an almost infinite opportunity for errors. On the flip side, the accuracy with which outside claim processors work is impressive, yet the few mistakes they make are costly. When you audit your plan continuously, the real-time data is invaluable. There's no better way to stay on top of things and manage actively. Your processor will likely find systemic errors that occur in large, repeating patterns. But your auditor can find individual ones that are equally worth correcting.
All of the improvement in claim auditing has been driven by a few cutting-edge firms that have developed unique systems and methods. Their command of electronic review design has quietly revolutionized the industry over the past few years. A level of detail and accuracy that was once unimaginable is now familiar today. It informs providers and processors that plan managers are well-spent and have options to provide meaningful oversight. The knowledge keeps them on their toes and assures you of optimal performance. You'll see a consistent performance improvement.
Schedule one today if your post-pandemic review still needs to include an audit. Regardless of the data you have in hand already, having something to compare it against is insightful. It would be possible but highly unusual for an auditor to find nothing of benefit to you. Even plans with ultra-low claim processing error rates can benefit from auditing. Tightening up irregularities and understanding them to prevent future ones is good management. When auditors are double-checking and reporting their findings, you have an independent analysis of plan performance that you can trust.