Does Pre-Certification Guarantee Payment?
In healthcare, a doctor’s priority is to provide the best care for a patient. However, this can sometimes mean deviating from our industry’s processes and regulations. One such process is pre-certification, also known as prior authorization, which may be required by...
We Can Help Secure a Stop-Loss Quote for Groups that are Currently Fully Insured
USBenefits can assist you and fully insured clients to consider if stop loss is appropriate for their needs. To help us properly and expeditiously review your RFP, all fully insured submissions are subject to the following in addition to our underwriting guidelines....
Why it’s Essential to Review In-Network Claims
By Mike Lanza In our industry, there is much hesitancy to review in-network claims for billing errors and unnecessary treatment. One concern is that an audit will take too much time and may violate prompt pay rules, but that concern should not prevent a detailed audit...
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...Latest News
Medical Stop-Loss Brochure
