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Why Your Employees Aren’t Getting the Benefits You Think You’re Providing

    
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Presenters: Marie Bowker, CEBS, and Debra Culbreth, Truven Health Analytics


February  2014 - This program is no longer available, the page is available for information purposes only.

Program length: 60 minutes
 
Are your employees really getting the benefits you think you’re providing? You might be surprised to learn the answer is often "no." In fact, research by Truven Health Analytics finds that up to 8 percent of claims are paid incorrectly.

The Patient Protection and Affordable Care Act (PPACA) mandates 100 percent coverage -- pre-deductible -- for many preventive services. You may think you are meeting these requirements. But in reality, your health plan or Pharmacy Benefit Manager (PBM) may be interpreting or implementing your plan differently. Conversely, you may think your plan is not paying for services like cosmetic procedures or non-emergency use of emergency departments; but it depends on your health plan’s system setup.

In this webcast, Marie Bowker, CEBS, and Debra Culbreth of Truven Health will explore the common reasons benefit plans are not always administered as intended -- and provide solutions to address these. In addition to discussing how incorrect payments can occur due to breakdowns in plan implementation, we will provide real-world examples based on our employer customers’ recent experiences with coding errors, lack of quality control, administrator system setup issues, and even fraud and abuse. Ultimately, you will learn how to maximize the financial performance of your healthcare benefit and provide the employee benefits you committed to provide.

 

About the presenters: Marie Bowker, CEBS, is senior director of Practice Leadership at Truven Health Analytics. Debra Culbreth is the team lead of Truven Health Analytics' Health Care Claims Auditing service.

 

Recertification Credit

Viewing this entire presentation, either as a live event or archived, counts for 1 credit hour toward PHR/SPHR/GPHR recertification from the Human Resource Certification Institute. Note: You are responsible for tracking your participation in this event.

 

Webcast Sponsor

This webcast is sponsored by Truven

 

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