Compliance
Compliance

HealthComp employs a staff of individuals dedicated to helping your Health Plan maintain compliance with applicable laws and regulations, including the new HIPAA, HITECH and PPACA regulations.  Our Compliance Department is continually monitors new legislation, Dept. of Labor, IRS and CMS regulations and bulletins, and court decisions, which may impact the administration of your Company Health Plan.  Because our Compliance Department is in-house with access to all other departments, we can work with you to ensure any necessary adjustments to Health Plan administration are efficiently and seamlessly integrated.

Plan Documents:  HealthComp is prepared to consult and assist you in the preparation of your Company Health Plan Document by utilizing specially designed software that supports its preparation. This software contains legal language that is continually being updated by a panel of ERISA attorneys.

5500 Forms:  HealthComp is prepared to complete and file the required legal filings, such as the annual 5500 Form and schedules.  We request, gather and compile the necessary information to complete the 5500 Form, such as claims data, insurance premiums, commissions and other vendor payments.

Amendments:  From time-to-time, you may wish to modify your Plan Document for benefit or eligibility changes. There may also be times when your Plan Document needs to be amended for legislative changes. HealthComp is prepared to assist you in the preparation of the necessary amendments, as well as the preparation of the appropriate communication to your employees, such as booklet inserts.

Auditing:  HealthComp repeatedly analyzes accuracy levels. During the first 60 days following each client's implementation, our Quality Assurance staff processes all claims to assure proper programming and training has been completed.  Ongoing audits are performed utilizing a system-generated random sample examining five percent of all claims paid.  All high-dollar claims (more than $5,000) are audited and approved before being released for payment.

Subrogation:  HealthComp dedicates experienced full-time personnel to protect both the Plan’s right to subrogation and the Plan's priority right of recovery. Our claims examiners review all claim submissions for potential subrogation or third-party liability.

Our staff utilizes several indicators to identify potential subrogation or third-party liability. If any of these indicators are present, the examiner presents the claim(s) to the Subrogation Department for further processing. The Subrogation Department then sends a lien notice to all related parties such as the employee, attorneys and all associated insurance companies.

HealthComp is prepared to assist in the pursuit of potential recoveries, utilizing both internal and external legal professionals during this process.

divider