Group-purchasing program identifies cost-saving opportunities within health benefit plans
PITTSBURGH, Pa.,March 17, 2009 — As the economy continues to erode and healthcare costs continue to climb, the Pittsburgh Business Group on Health (PBGH) has developed a group-purchasing program for Employer Members that will enable them to immediately identify significant cost-saving opportunities at a discounted rate.
Through an agreement with BMI Audit Services (BMI), PBGH is offering Employer Members medical claims auditing and dependent eligibility auditing services as part of its ongoing effort to provide employers with meaningful programs that help them control healthcare costs.
BMI is offering discounted fees to PBGH Employer Members in addition to a range of other discounts of up to 15 percent, depending on the number and scheduling of audits. With government projections indicating that healthcare costs will climb to $8,160 per person in 2009, the discounted service is even more valuable.
By validating each medical claims administrator’s compliance with proper claims adjudication practices relative to each Employer Members’ benefit plan and by reducing the number of ineligible dependents employers are covering, employers can realize considerable savings in premiums, claims, administrative fees and other possible costs.
“In today’s economy, it is especially critical for employers to continually identify ways to control their healthcare costs,” said M. Christine Whipple, executive director of PBGH. “We are excited about this new relationship with BMI because it helps employers do just that. BMI has a strong track record of assuring clients that important healthcare benefits are paid with procedural accuracy and financial integrity.”
The federal government estimates that approximately three percent of the nearly $2 trillion spent annually on medical care in the United States represents improper payment due to error or inadequate provider documentation. Further, anywhere from three to 12 percent of current covered dependents may be ineligible for health insurance, depending on employee demographics and complexity of the eligibility criteria. Therefore, many employers have been undertaking dependent eligibility audits as part of a growing nationwide trend.
BMI has developed an innovative approach to assessing the administrative effectiveness of medical claims by combining proven audit methodologies with advanced technology. BMI uses computer-aided systems, human logic and onsite reviews to test 100 percent of all claims, allowing it to uncover all possible misinterpretations of plan language by administrators and employees alike.
“We are honored to have earned this opportunity to work with PBGH and its Employer Members,” said Randall Light, BMI’s managing partner. “Our investment in technology and people is the key to our ongoing success and our ability to support employers’ efforts to maintain competitive benefits plans.”
About the Pittsburgh Business Group on Health
Founded in 1981, the Pittsburgh Business Group on Health (PBGH) is a non-profit organization and business-only coalition representing more than 60 Employer Members, more than 800,000 employees, dependents and retirees, and over $4 billion in health care expenditures. The organization strives to improve the delivery, cost and quality of health care by implementing and supporting quality initiatives, analyzing health care data and resources, and providing forums for exchange of ideas and viewpoints. Visit www.pbghpa.com for more information.
About BMI Audit Services, LLC
BMI Audit Services, LLC (BMI) is a premier healthcare benefits auditing firm based in South Bend, Ind. BMI has been providing healthcare claims auditing services and dependent eligibility auditing services since 1998. Its client base of mostly self-funded employers ranges from Fortune 500 firms to employers with less than 200 employees. For more information, visit www.bmiaudit.com.
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