When asked to offer his best advice for other brokers, Mike Kerns, a veteran broker from Ohio, said to always first think about your client and their employees. The fact this even needs to be said — much less is the best piece of advice from an experienced broker — tells you the primary concern plan sponsors should have is a broker’s motivations.
October 2024 | Get the latest from the best RBP advocates and auditors
Industry Perspective
Omar Arif
Senior Vice President of Growth
What to Pay Your Broker
Whether it is LinkedIn or conferences we are inundated with conversations bashing benefits brokers. I wanted to take an opportunity to flip that around and help plan sponsors reconcile the relationship between sound advice and broker compensation.
The latest episode of our podcast, ClaimTalk, is the first half of a two-part discussion with brokers. If you are involved in the benefits space — as a business owner, in human resources, as a CEO or CFO — you really should tune into these episodes for an inside look at the broker role and the process they go through when considering alternatives. With your responsibility to properly hire and retain a broker, this is tremendous insight for you to understand how that side of the business works. When asked to offer his best advice for other brokers, Mike Kerns, a veteran broker from Ohio, said to always first think about your client and their employees. The fact this even needs to be said — much less is the best piece of advice from an experienced broker — tells you the primary concern plan sponsors should have is a broker’s motivations. Read more...
Audit Spotlight
Cynthia Swanson, RN, CPC, CEMC, CHC, CPMA
Senior Audit Manager
The Merit of Auditing Healthcare Claims
Successful auditing of medical claims does not merely identify problems, it also pushes healthcare providers to bill honestly and follow coding and billing guidelines/regulations, assists in the prevention of improper payments, and reduces healthcare spending.
As healthcare costs continue to climb an upward slope, an escalated need exists for closer auditing of healthcare claims to identify egregious charges, improper medical coding and billing errors, duplicate billing, and associated improper claim payments. Read more...
DirectAccess+ Savings
DirectAccess+™ clients and members achieve maximum protection and savings. To establish savings information, ClaimDOC analyzes commercial contract pricing from data disclosed by hospitals and health plans. The audit team performs line-by-line claim audits to help clients and members maximize their savings. Below is one recent audit result showcasing substantial savings.
Cincinnati, Ohio
Eleven-day hospital stay for the treatment of esophageal cancer and related surgery
Disclaimer – The analysis of any medical billing or coding is dependent on numerous facts, regulations, payer policies and codes, as well as the controlling plan description. The information contained herein is intended to provide a real-life example of opportunities for savings through ClaimDOC services but is not intended to provide medical, legal, or financial advice.
Member Experience
Feedback From a Member
"Cori is phenomenal! She is deeply empathetic, communicative, and went above and beyond finding a therapist for me. Cori exemplifies what customer service is really about. Thank you for not giving up on your members. Keep it up! And thank you again!"
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ADVISORS UNLEASHED — PART 1
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