Use a variety of easy-to-understand educational resources to learn more about DOL audits and assess your organization's compliance.
Over the past few years, the DOL has ramped up its enforcement of federal laws. Attorney-created resources can help you learn about your compliance obligations and make sure you are following the DOL's rules.
Prepare for DOL audits of your health plan with this comprehensive guide that explains why certain health plans are selected for audit, provides tips for preparing for (and avoiding) an audit, and describes what is typically required of an employer during a health plan audit.
Eligibility Auditors report that the typical dependent eligibility audit removes 5%-12% of ineligible dependents from a health plan, resulting in substantial plan savings while creating a fair environment for all employees and their eligible dependents.
With the cost of healthcare steadily increasing, it is important for Health Plans to consider use of their plan services.
Although Health Plans have criteria that define eligible dependents, experience shows that there are ineligible dependents taking advantage of the Health Plan benefits. Many plans have complicated eligibility definitions and your employees may not even be aware that their dependents are no longer eligible. Ineligible dependents increase administration costs, claims costs and liability. These claims are not eligible for stop loss reimbursements. These factors combined can be a costly oversight. Employers have a responsibility under ERISA to ensure that plan funds are used for the sole benefit of employees and their eligible dependents.
Your dependent eligibility audit should be handled by professionals that treat the task with the sensitivity that it deserves. We will communicate with your employees to collect the necessary, required documentation for dependent eligibility verification. When the responses are received by ENV, the documents are reviewed and verified to ensure each member individually meets your Health Plan's eligibility requirements. If required, eligibility changes will occur in a compliant method. All participants' audit responses are stored electronically for reference.
ENV has access to Cost Containment Strategies that combine superior market intelligence, advanced technologies & some of the nation’s leading overpayment recovery experts who specialize in deep dive audits and reviewing 100% of claims. Some areas of review are duplicate billing and coding errors based on the complexity of reimbursement codes.
Mistakes happen, and no business, no matter how great and efficient, is perfect. ENV’s Cost Containment Audits can assist in isolating errors, minimizing negative effects by identifying and addressing all problem areas. Partnering with ENV offers long-term, bottom-line conscious risk management that’s essential to any business that aims for consistent success.
It’s important for any organization to have a complete, accurate understanding of their expenses. Not only will a Cost Containment Audit identify and assist in resolving duplicate billing and coding errors, but a Cost Containment Audit may identify other errors or improvement areas. ENV Financial Services agents are professional, knowledgeable and experienced. For 25 years, ENV has helped businesses manage risk, and assisted in financial concerns, helping identify and resolve problems that arise. ENV Financial Services agents understand that not every situation is the same, and will treat you and your organization with a personable approach that will satisfy your unique needs and concerns.
Our Cost Containment Audits can help you pay only what you deserve to pay, properly managing financial mistakes to minimize the financial burden that can be imposed from duplicate billing and coding errors.
Cost Containment Audits can be complex and detailed. That’s why it’s so important to have your Cost Containment Audit done by an experienced, professional organization. ENV has been helping businesses reduce and fix financial issues for over 25 years!
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