Claim Success Stories – Refund for Unnecessary Treatment
At USBenefits, we believe the goal of cost containment is to ensure the Plan is not paying for any services that are excluded according to the Plan document. This means not only looking for billing errors, but also treatment misadventures that could cost the Plan tens...
How do you compare Stop-Loss Carriers/MGUs?
What’s the most important aspect of shopping for stop-loss insurance? The first response is usually the lowest price, and maybe a distant second is name recognition. However, you rarely hear claim handling even being mentioned. So why is that? Probably because no one...
What Should Self-Insured Plans do to Prepare for a Possible Recession?
With inflation at 40-year highs for almost a year now, and the Federal Reserve raising interest rates to combat inflation, there are predictions of a recession in 2023/2024. What can a Self-Insured Plan do to keep medical costs down to retain employees during the...
Supporting the Best Interest of the Employer: How Stop-Loss Providers can Help TPAs
In a recent discussion with employers, most knew they had Stop-Loss coverage for their self-funded medical plan. They further understood that it’s protection from a large loss. However, there was some confusion as to the role and relationship between the Claims...
Underwriting and Sales are Motivated Differently to Write the Same Account
A natural and healthy conflict exists between underwriting and sales. It's easier to manage when the underwriting and sales (producers) are separate entities. However, many stop-loss carriers/MGUs (carriers) compensate their sales (marketing) staff in a similar manner...
Your Stop Loss Carrier Should be Your Trusted Advisor
What is a ‘Trusted Advisor,’ and why is this important to you? There are several references on what a trusted advisor is. Simply put, it is a person and company that does not act only as a facilitator to your inquiries or needs. A trusted advisor will offer an...
Claim Success Story #6 – Chemotherapy
At USBenefits Insurance Services we take pride in our ability to identify potential claim issues to ensure the Plan is not paying for items that should not have been billed by the provider. In our most recent example, the claimant was undergoing chemotherapy over many...
Reasons Employers Should Use ACH Payments Over Paper Checks (Part 4)
(Part 4 of 4) Are you using Automated Clearing House (ACH) to make and receive payments? ACH is an electronic application that allows the direct transfer of funds between two bank accounts with several benefits to all parties. Preferred method: Usage of paper checks...
Reasons Employers Should Use ACH Payments Over Paper Checks (Part 3)
(Part 3 of 4) Are you using Automated Clearing House (ACH) to make and receive payments? ACH is an electronic application that allows the direct transfer of funds between two bank accounts with several benefits to all parties. Faster processing: Paper checks are sent...
Reasons Employers Should Use ACH Payments Over Paper Checks (Part 2)
(Part 2 of 4) Are you using Automated Clearing House (ACH) to make and receive payments? ACH is an electronic application that allows the direct transfer of funds between two bank accounts with several benefits to all parties. Recurring reminders: Stop loss has...
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