Medical Claims Audits for Small and Medium Businesses
Followed Up with Continuous Monitoring of Benefits Claims
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Our Claim Audits and Continuous Monitoring Improve Plan Performance
A full-service medical claims audit from TFG helps mid-size and smaller companies serve employee needs while improving the bottom line. Our processes and methods have advanced through the years, and no other benefit auditing firm can match budget-neutral audits and ROI. The most effective use of our services is to follow an audit with our continuous claims monitoring service. We catch errors in real-time to help you serve employees better and manage costs.
Our competitors try to be many things. We are 100-percent focused on medical claims auditing and monitoring, and it gives us an edge in quality and service.
Example #1: Outpatient Medical Services Provider
Costs reduced after a full-service audit
West Coast-based nationwide outpatient care medical services provider with more than 3,000 employees enrolled in four separate plan designs.
The client had not undertaken an audit of the administrator in several years and determined that a thorough due-diligence review of the administrator was warranted.
Also, the client needed operational-cost reductions, and a consultant recommended a comprehensive audit of health benefit expenses.
Example #2: Small Manufacturing Company
Audit and audit strategy to meet government requirements
A smaller division of a nationwide Fortune 500 manufacturing company, with a group of less than 200 retired employees, under a single health benefit plan.
The client needed to meet the fiduciary compliance requirements of ERISA and Sarbanes-Oxley Acts for a number of self-insured, legacy health plans.
The plans had not been audited for many years. The company needed to establish a systemic plan audit strategy.
A TFG Full Service Claims Audit and Monitoring Can Make All the Difference
We’re a unique benefits plan auditor with a full-service approach. Since 1992, our services have focused on corporate medical plan audits. But it’s what else we that makes a difference for our clients.
We begin with the industry’s most thorough audit, then analyze the data, provide helpful advice based on our findings — and do everything we can to fix ongoing issues and help with recovery in problem areas.