Money, Time and Performance: 3 Critical Health Plan Audit Statistics
Money, Time & Performance:
3 Critical Health Plan
THE FISCALLY RESPONSIBLE THING TO DO
The right audit shows whether your carrier is correctly spending your money. If you put millions of dollars every year into your health plans, why wouldn’t you audit the carrier to ensure they’re doing a good job for you?
99% vs 99.3%
What’s the difference?
For an employer spending the U.S. average of $14,800 per year per employee on health benefits, the difference between 99% and 99.3% accuracy is $1,376.40 per employee.
ENSURE EFFICIENT DELIVERY OF ACCURATE PAYMENTS
This is the time from the date an insurer receives all the information necessary to process a claim to the date the claim is processed.
For insurers, claim handling time is critical to getting provider discounts (which save you and the insurer money).
You need to know your vendor is not only paying claims accurately, but paying them timely.
Aon’s minimum satisfactory goal is 92% in 14 calendar days and 99% in 30 calendar days.
DON’T TRUST THE FOX WITH THE HENHOUSE
Most vendors agree to performance guarantees, and failing to meet them can affect their fees. Too often, performance guarantees are self-measured and self-reported by the carrier.
You don’t go through life completing your own report card. Why wouldn’t you get someone to verify your carrier’s self-reported results?
First Call Resolution
90% on first contact
Average Speed to Answer
30 seconds or less
Call Abandonment Rate
3% or less
getting the right plan audits from the right partner will give you three powerful tools for fulfilling your fiduciary responsibilities:
Trust but verify
Know how well your vendors are doing, beyond self-reporting.
Meet fiduciary due diligence
Know and demand appropriate responses to all Department of Labor suggestions.
Validate vendor performance metrics
Find problems early and ensure there’s an action plan for resolution and to prevent future occurrences.