Do you have 100% confidence only eligible members are receiving healthcare benefits?
“Eligibility leakage” often represents a minimum of 2% of healthcare costs. For every 1,000 employees, this waste costs a plan $160,000 annually! For a business operating on a 5% profit margin, this translates into over $3,000,000 in revenue. Dependent eligibility leakage can cost another 3%, or an additional $240,000.
Our proprietary employee eligibility technology identifies suspects in three categories:
- Point-In-Time (e.g. low hours worked, beyond termination, beyond COBRA)
- Secondary (e.g. subrogation, Medicare, coordination of benefits)
- Non-Subscriber (e.g. premium mismatch, coverage tier mismatch)
While our technology helps management objectively address “eligibility leakage” root cause, such as ineffective business processes, broken carrier enrollment feeds, data integrity, ineligible dependents, one-sided contracts, and limited reporting, our proven team helps plans monetize costly eligibility-based errors. Best of all, well over 95% of the actual work is performed by HR Best Practices!
Contact us now to arrange for a demo.
