AHA Endorsement:

Dependent Eligibility Audit Services

“HMS Employer Solutions made our recent dependent verification process a breeze. From holding weekly status update calls, to dealing with numerous employee questions, they were in charge every step of the way. The verification process saved our Hospital a great deal of money and also helped to clean up our benefit plans.” — Meghan Levin Donahue, Carroll Hospital Center

For a self-insured employer, running an employee health care plan can be a difficult job. Managing which employees require which policies, how many dependents they have and how much you'll be spending on them is integral to keeping costs low and employee loyalty high. Conversely, employees claiming unqualified dependents represent a significant unnecessary claim expense on your organization. A hospital seeking innovative ways to contain costs will benefit from services that assist it in ensuring that only eligible individuals are on the employer health plan.

Why We Endorsed Dependent Eligibility Audit Services from HMS

Working to implement the policies of the health reform law, it is imperative that hospitals balance the ability to attract and retain the best talent, while ensuring the organization's money is spent appropriately. We explored a number of audit solutions for self-insured employers and exclusively endorsed Dependent Eligibility Audit Services from HMS because of its health care focus and employee-sensitive approach. HMS brings a proven history of cost-containment programs to a field proactively seeking new ways to minimize spending without sacrificing high-level patient care. A key differentiator of HMS is its scalability, allowing the Dependent Eligibility Audit Services to work effectively for health care organizations both large and small.

Understanding Dependent Eligibility Audits – Straight to the PointTo Contain Costs Conduct Your Audit Now Before Fall Enrollment Season
Are all your dependents eligible for coverage under your employee benefits plan?

Beginning in 2014, the U.S. Department of Health and Human Services (HHS) is requiring all self-funded employers to pay a new fee, estimated at $63-per-health care-plan-participant, to fund a Transitional Reimbursement program legislated by health care reform. Transitional Reinsurance fees will partially reimburse commercial insurers writing policies for individuals with high health care costs.

Learn how HMS Dependent Eligibility Verification solution will ensure that only eligible dependents are covered on your plan before your next enrollment season is here. Access Resources Online>

Dependent Eligibility Audit Services from HMS allow health care organizations of all sizes and specialties to dig deep into their employee health care plan to discover ineligible dependents receiving benefits. Life changes like marriage, divorce and grown children can unintentionally result in non-eligible dependent claims. Regardless of cause, organizations using HMS Services will benefit from compliance with new and existing regulations and a guaranteed return on investment.

show more +