HR Best Practices

Containing Health costs through Data Mining

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Healthcare Auditing

Do you have 100% confidence…?”
  • Medical Claims are being paid properly – Discounts are being realized? Duplicate payments are not being made? Stop loss payments are accurate?
  • Case management is working effectively?
  • Disease management programs are optimized for members with various conditions, such as Diabetes?
  • Claims are not being paid by both the health plan and the worker’s compensation plans?
  • The pharmacy plan Is being administered consistently with the contract terms and plan design – Discounts are being realized? Rebates are accurate? Co-payments are accurate? Limits and exclusions are being enforced?

Since our solutions employ 100% of the data: census, enrollment, COBRA, medical claims, pharmacy claims and worker’s compensation claims (optional), our results are always more compelling than statistical audits performed by big HR consulting/brokerage firms and accounting firms. Moreover, we’re truly independent – we will do what’s right for the plan, not because of our relationship with the TPA, PBM or payor.

Contact us now to arrange for a demo.

 
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NEWSFLASH:  Subrogation specialists “estimate that between 1% and 3% of health-care spending is potentially recoverable to the health plan.” Wall Street Journal, November 20, 2007 Read More (subscription required) - Learn More about Subrogation

Customer Quote

Chief Internal Auditor

“HR Best Practices goes beyond the normal practice of manual sampling and testing of claims by using advanced software they have developed to do extensive data mining and analysis of your full population of claims.  The HR Best Practices team is not only expert in the health care field; but the team also has a real passion for healthcare auditing and cost containment”.