ARE YOU relying on your 'big carrier' TPA to...
HOW would you know...
without communicating with the healthcare providers that your members know and trust?
WHY should you care?
Your TPA may be engaging in other activities that directly impact your plan members, their access to benefits, as well as what is happening to plan assets AFTER claims are paid.
Not only might this activity be costing you money, your TPA just might be capitalizing in unknown-to-you ways on their contract with you outside of agreed-upon avenues for their own financial benefit.
Predatory activity that carriers have been weaponizing against their own participating providers and healthcare facilities for years has been a way for them to capitalize on their contracts with YOU.
Activities such as:
Through aggressive audit recovery and egregious denial practices, they enrich themselves using these activities as alternate streams of revenue. This applies to both public and corporate plans of all sizes.
With new data transparency laws, and enhanced oversight of plan management, 2023 is the time for...
~ Dr. E
Whether you are a state or corporate self-funded health benefits plan, NOBODY is watching.
Shocking, isn't it?
It is completely up to you, in fact, it is your fiduciary responsibility and no one else's, to monitor all TPA behavior.
Check out my short Explainer video "Whose Money is it Anyway" for more details.
You've got the data (or at least I HOPE you do!), so you know who they are.
These providers and larger healthcare facilities are waiting for you to reach out to them. I can help..
FIXING this problem will require targeted investigation unlike plans have been utilizing in the past, and the sharing and collaboration between these MANY diverse individuals and professional communities and industries.
This is EXACTLY what I have been doing since 2018.
CURIOUS? I hope so!
Doubtful? Let's talk. You have nothing to lose: There's no charge for an initial 30-minute consultation.
923 N. Kenmore St Arlington VA 22201
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