Self-Funded Employers
Case Study / Testimonial
Enrollment Verification
Since 1985 Health Decisions, Inc. has been helping self-funded companies manage employee health benefits. Self-funded employers rely on Health Decision’s proven ability to save money - typically 2-3 percent of claim costs.
Health Decisions offers the most comprehensive and sophisticated Post Payment Claim Recovery Service in the industry. Nobody addresses more areas of claim recovery or recovers more money per client than we do. In addition, we will develop customized recovery applications requested by the client at no additional cost.
Health Decisions goes much deeper seeking claims to recover by conducting a review of 100 percent of claims in more than 25 areas to identify and recover claims paid that are not the employer’s responsibility.
Many employers suspect that greater savings can be generated through aggressive claims administration, including coordination of benefits, but few are even aware of the potential for even more savings through aggressive eligibility administration.
Beyond providing opportunities for claim savings, the Health Decision review offers employers the most comprehensive and affordable approach to claim auditing available.
Our audit capabilities extend to the reconciliation and verification of enrollment information. Health Decisions assumes the technical and tedious aspects associated with enrollment reviews which gives employers the ability to address claims recovery management without disrupting current staff assignments.
Our proven claim auditing process includes use of Health Decision’s specialized staff to conduct a complete Enrollment Verification Survey of all covered persons with the full range of information needed for claim administration and regulatory compliance.
Health Decisions also gives employers direct access to claims, enrollment, and all other plan data in easy-to-use Microsoft or web-compatible formats.
All of our services allow employers to document in a tangible manner their fiduciary responsibilities and provides a means for employers to satisfy HIPPA requirements.
Companies ranging in size from one site with 100 employees to multi-site corporations with thousands of employees have discovered that Health Decisions provides the technical expertise that will help control benefit costs.