Jul 18, 2024 | Claims, Claims negotiation, Compliance, Subrogation
If one of your plan members is injured as the result of an accident, it’s possible that subrogation may be necessary. Subrogation is a recovery process in which medical claim costs resulting from the injury, initially covered by the employer, are reimbursed from...
Apr 2, 2024 | Case Studies, Claims, Claims Management, Claims negotiation, Cost Savings, Forensic claims review, Savings
Claim savings don’t have to end with the PPO network discount. With MedBen’s forensic claims review services, savings are produced after network discounts are applied, but before claims are paid. As the case study below shows, while PPO network discounts alone...
Feb 1, 2024 | Balance billing, Claims, Claims negotiation, Cost Savings, Health care costs, Out of network, Unwrapped
Even with a solid primary network plan in place, expensive out-of-network medical bills can result in higher-than-expected health care costs. To guard against this, MedBen offers Unwrapped, a comprehensive pricing solution that reduces your billed changes by an...
Nov 27, 2023 | Case Studies, Claims, Claims negotiation, Cost Savings, Forensic claims review
A MedBen client realized an overall savings of 62% through repricing, forensic claims review, and provider negotiation. The client in question received a claim for IV infusion to a member with iron deficiency. After the PPO discount, MedBen saw an opportunity to...
Feb 8, 2022 | Claims negotiation, Cost Savings, Discounts, Forensic claims analysis, Out of network, Savings
A MedBen Client received a $160,109 claim for an out-of-network back surgery. After the claim was repriced, the unusually high cost for this procedure was flagged by our claims surveillance. Due to this, a MedBen-contracted orthopedic specialist reviewed the claim and...
