Health Care Cost Savings

Recently I wrote an Article that appeared in the 4th Quarter of one of my industry's leading trade magazines, Benefits Quarterly, titled "The Need for Better Transparency in PPO Claims Processing" . Here is a brief recap:

The Need for Better Transparency in PPO Claims Processing

by Brandon Guest, CEBS, Arthur J. Gallagher & Co.

Lack of transparency in preferred provider organization (PPO) insurance claims processing can result in corporations paying hundreds of thousands of dollars in hidden fees and charges. This article explores how fees can be hidden within claims reports when plan participants receive services from providers that are not within the PPO network but claims are repriced and treated as in-network or are repriced by out-of-network providers. It also provides some insight on what plan sponsors should look for when reviewing claims reports and appendixes

The point I am making here is that Health Insurance companies and TPA's are masters of disguise. It takes someone with a great deal of knowledge to not only recognize where money is being hidden from view but how to negotiate these fees into the renewal process to lower your healthcare spend. If interested in learning more I am happy to talk with you and share what I know.