What is enrollment verification anyhow?
Enrollment verification is a process of reviewing the enrollment records of self-insured companies and health insurance payors to make sure they are correct.

What kind of errors does enrollment verification uncover?
The most common errors identified are ineligible enrollees, duplicate enrollments, and out-dated records.

How do these types of errors occur?
Communication breakdowns and gaps occur in the many points of data sharing from dependents to employees, from employees to HR staff, from HR staff to payor staff, and from one payor department to another. When any link in the communication chain fails we correct the information and repair the broken link.

How important is enrollment verification?
It’s critical! Health Decisions demonstrates time and again that far greater savings are captured through enrollment verification than through improvements in claims recovery procedures.

How is enrollment verification done?
The key elements of Health Decisions unique process includes:
• Reconciling payor records from multiple plans to assure non-duplication.
• Verifying that payor enrollment files agree with payroll and employer rosters.
• Surveying enrollees and covered members to confirm and update all relevant facts.

Tell me about the survey?
The survey done by Health Decisions specialized staff is sent to all employees, retirees, spouses and dependents to get all the information required for claim administration and regulatory compliance. For more than 10 years Health Decisions has achieved response rates of 90 percent on its purely voluntary surveys.

How many companies are offering this enrollment verification service?
Most claim recovery firms do not offer enrollment verification. Health Decisions, Inc., is the only one doing enrollment verification in the payor market and one of the very few in the employer market. No one comes close to Health Decisions in offering as comprehensive enrollment verification with comparable results.

Why is Health Decisions out in front on this service?
Health Decisions is the first and only claims recovery firm involved in Post Payment Administration, a process we pioneered. After everyone else is finished looking, Health Decisions applies its expertise, methodology, and powerful software and digs even deeper to uncover money for self-insured companies and health insurance payors.

How reliable is your company?
In business since 1985, Health Decisions is the most experienced, independent, continuous health claims recovery and post payment administration firm in existence in the U.S. Health Decisions offers a total solution, not just a recovery initiative, and Enrollment Verification is a key tool used as we seek total solutions for our clients.