Audit Claims Medical Claims For Cost Containment

Errors in medical bills and the claims filed to pay them to add up to millions of dollars annually. Therefore, corporate and nonprofit employers that self-fund their plans increasingly use health plan auditing services for oversight. As claim payments have increasingly moved out of house to third-party processors, sponsors rely more on auditing as their backstop. Health insurance carriers that act as TPAs have a high degree of accuracy, and error rates are kept low. But because the dollar amounts of claims are high, even a tiny percentage can significantly affect a sponsor’s bottom line.

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