Audit

Benefit Intelligence offers comprehensive auditing services. Although most health care claims are processed with highly automated claims payment systems, insurance companies and third-party administrators still rely on human effort to make those systems work. Consequently claims errors can result from human misinterpretation of plain language, flawed record keeping or other factors. Benefit Intelligence's audit services can reduce the headaches caused by errors, by effectively helping you and the claim administrator implement corrective actions to minimize errors.

  • Annual Actuarial Report
    • Provides recommended funding, COBRA premiums, reserve estimates, etc. Modeling by actuarial principles is used.
  • Benefit Content Analyses
    • Actuarially-determined economic values of Benefit A and Benefit B are compared without and/or without regard to reported claims experience.
  • Risk-Related Analyses
    • Involves health care plans where both (a) risk-related plan changes including demand management and (b) consulting to other risk’s/funding arrangements are involved.