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Rise In Million-Dollar Claims Emphasizes Need For Smart Benefits Management

06/19/14

  10:07:15 am, by MedBen5   , 261 words,  
Categories: News, Health Plan Management, Health Care Reform, Stop-loss

Rise In Million-Dollar Claims Emphasizes Need For Smart Benefits Management

Occurrences of million-dollar medical claims are still comparatively small, but their numbers of late have grown considerably – another reason it pays for your business to take advantage of the sound health benefits management offered by MedBen.

According to Business Insurance, a new report by financial services company Sun Life finds that the incidence rate for catastrophic medical stop-loss insurance claims in excess of $1 million more than doubled in 2013 to 4.3 per 5,000 claims, compared with incidence rates of 1.8 in 2012 and 0.4 claims in 2010.

“We anticipate costs will only continue to rise as new technologies are adopted, advanced drug therapies are introduced, and the Affordable Care Act increases access for participants,” said Karin James, a vice president for Sun Life’s stop-loss division.

Without the safety net of a benefit ceiling, large claims take on an even greater significance – and with the rate of million-dollar claims growing, just one unhealthy claimant can impact the bottom line. But with MedBen’s self-funding solutions, we help employers reduce the potential risk.

MedBen reviews every claim for inappropriate codes and loss potential, but our advanced claims surveillance techniques place a special emphasis on bigger bills and inappropriate procedures. When we flag a questionable claim, medical specialists work directly with the provider to ensure an outcome that’s both cost-effective and patient-sensitive.

MedBen will help you find the right self-funding solution based on your group’s size, the amount of stop-loss protection, and your preferred level of involvement – and save you money. To learn more, contact, Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

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