Is it Time to Audit Your Carrier Bills?

Sometimes, something that’s supposed to be predictable, like a bill from your company’s insurance carrier, comes with surprises. What happens, for instance, when an employee receives a bill from your carrier that includes services they didn’t use? Typically, the first place they look for answers is HR.

Auditing carrier bills can help drive accuracy

Carrier bill audits can help companies achieve long-term benefits objectives.

In many instances, companies call on auditing teams to review health plans and medical claims, often by examining a sample of claims that represent the breadth of a company’s benefits plan.

  • Bill audits help check financial and payment accuracy, make sure claims are categorized correctly, and help ensure that payments and distributions happen in a timely fashion.
  • Audits can also help administrators and companies uncover ways to improve the claims process in the future.

From a day-to-day perspective, audits can help resolve issues related to discrepancies and billing issues. This can be helpful when:

  • An employee uses a medical service that the company doesn’t cover;  
  • Employees get billed for services they didn’t receive; or
  • There’s a case of duplicate payments.

If you’re using benefits administration software to help manage your benefits plan, then your software can help you save time when it comes to reviewing carrier bills. Below, we’ve highlighted three ways that your benefits administration software can support your plan auditing process.

Measuring cost accuracy is one of the top reasons to audit carrier bills. Monthly list bill audits can help make sure you and your carrier are on the same page where billing and usage are concerned. BeneTrac provides these monthly audits to clients at no additional costs. Request a demo, and learn more.

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Insurance bills illustration

Running bill audits

Make carrier bill audits a strategic part of how your company manages and administers its larger benefits plan. 

Running a carrier bill audit is not about finding a quick fix. While many companies use outside benefits consultants to lead health plan audits, HR is often heavily involved at the start and end of the auditing process.  

  • Perhaps you run plan audits as a pro-active measure. For instance, you might want to be sure you’re fulfilling compliance obligations. Or, you might be planning major changes to your benefits plan, and want to review data to current costs.
  • In other cases, you might find yourself in a reactive mode. Perhaps you’re changing plan administrators, or there’s an unexpected spike in costs, and you want to get to the bottom of it.

Whether you’re running an audit proactively or reactively, your benefits administration software can help simplify the auditing process, increase accuracy, and save you time.

1. Review accuracy of carrier invoices

Your software can match bills against transactions made. This can help confirm that transactions appear correctly on bills.

  • If your audit uncovers errors, your benefits administration software support team can help you align data in order to address them.  

2. Save yourself time, and reduce costs for your company

When your benefits administration software syncs up with other HR tools, it can be easier to keep track of important dates related to an employee’s history with the company, such as starting date, dates of promotions, or termination date.

  • Perhaps you terminated coverage for an employee who no longer works at your company. However, the termination notice might not have been applied correctly into your carrier’s system. That means you might still be paying for this employee’s coverage.
  • Your audit can help uncover this type of discrepancy, and recoup unnecessary expenses.

3. Help ensure the timely delivery of employee enrollments
Enrollment errors can put your employees at risk of a number of things they’d most likely rather avoid.

  • Their claims can be denied.
  • The carrier might reject their retroactive enrollment.
  • Depending in the size group and the carrier, they might wind up paying a late entrant fee.

When your benefits administration software includes auditing features and services, the system can catch potential errors, and help make sure employees are enrolled correctly.

  • It can also help make sure that employees are eligible for the benefits and claims they file, based on the plan type that’s available to their employee tier.

Run benefits and claims audits with confidence and efficiency.

Benefits plan audits can help you detect errors early, which can create cost savings for your company. When your benefits administration system provides auditing support, you can gain new levels of confidence, along with clarity.

With reports in hand, you can pinpoint discrepancies related to enrollment, employment tiers, premiums, and how employees are using benefits. You can also access useful support and guidance to help you correct them. Finally, you can use this information when you need to contact your carrier, and resolve issues quickly.

BeneTrac’s list bill audit service is a key part of the software’s overall quality-control process. It helps ensure that any data that flows between you, BeneTrac, and your carriers aligns. Contact a BeneTrac representative today to learn more.

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