HealthComp’s Cost Containment Department engages in direct negotiation of non-network claims, and some network claims when permitted. These negotiations utilize data from other pricing sources and scrutinization of itemized bills to identify excessive or improper charges. These direct savings benefit both the member and the Plan, and are done on a percentage-of-savings basis, no additional up-front costs or expense to the Plan.
HealthComp helps you ensure proper coordination of benefits, which can save your Plan from unnecessary expenses. We annually verify other insurance information from members which reduces the number of claims paid improperly as primary and saves the Plan money. HealthComp also reviews received claims to check for indications that there are other insurance policies covering the member which should be coordinating benefits.
HealthComp also performs the mandatory CMS §111 Reporting on behalf of clients, and assists with any Medicare or Treasury demands for reimbursement.
HealthComp provides comprehensive stop-loss reporting for our clients, including submission of claims to carriers and preparation of disclosure statements. HealthComp’s in-house attorneys will also provide support to assist in appeals of denied reimbursement claims when necessary. Upon request, HealthComp will assist Plan Sponsors by obtaining quotes from other stop-loss providers.
Each year Plans expend millions of dollars on individuals who were improperly enrolled on their Plans. HealthComp provides a comprehensive dependent eligibility audit program designed to preserve the Plan’s assets by ensuring that ineligible individuals are not improperly enrolled on the Plan: former spouses, girlfriends/boyfriends listed as a spouse, former step-children, nieces and nephews claimed as children, etc. HealthComp can work with you to determine how the Plan wishes to treat improperly enrolled dependents and how to help prevent recurrence.