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Empowering Employers & Increasing Value For Self-funded Clients
Employers who choose to offer health insurance benefits to their employees have two options for paying or funding those benefits. Those two funding arrangements are self-funded benefits and partially self-funded benefits. Self-funded Arrangement:In the self-funded benefits arrangement, the employers guided by third party administrators (TPAs) creates, defines, and establishes a benefit plan for their employees. In…
Self-funded Employers are Leveraging Medicare Claims Repricing Tool to Cut Costs, Not Benefits
As the world deals with the impact of COVID-19, one of the most common issues we hear about healthcare today is the cost. The various healthcare studies indicate that the cost of providing medical and pharmacy benefits will rise 5 percent more for three consecutive years. As a result, the companies that use the best-in-class…
What is Medicare Claims Repricing? Is Medicare Claims Repricing So Hard Anymore?
Medicare and Medicaid repricing system enables healthcare payers to efficiently manage healthcare provider data and automate claims pricing by leveraging its adaptive, rules-driven architecture. Medicare claims repricing can significantly lower, pre-negotiated rates which providers in the healthcare networks have already agreed. What is Medicare Claims Repricing? Medicare claims repricing is the application of the contract…