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Rise in Multi-Million Dollar Claims Stresses Need for Cost Management Solutions

06/07/17

  03:09:00 pm, by MedBen5   , 210 words,  
Categories: News, Cost savings, Third party administration, Self-funding

Rise in Multi-Million Dollar Claims Stresses Need for Cost Management Solutions

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The elimination of lifetime maximums on self-funded health plans has led to a spike in multi-million dollar claims... and an even greater need for the claims management solutions provided through MedBen.

According to the 2017 Sun Life Stop-Loss Report, the number of multi-million dollar claimants increased by 68% from 2013 to 2016. While this group represents only 2.2% of claimants, they accounted for 23% of all stop-loss claims reimbursements in 2016.

Even before the Affordable Care Act phased out lifetime limits, MedBen had in place an advanced surveillance system that thoroughly analyzed claims to ensure that they met medical necessity or billing standards. Now, as multi-million dollar claims become more common, this system ‒ which uses over 125 certified medical specialists to review flagged claims and look for possible solutions ‒ is even more valuable for employers looking to control health care costs.

MedBen also helps clients to reduce the impact of high-dollar claims through customized plan language. Through the use of carve-outs for specific diseases and other focused strategies, employers can better manage their spending without sacrificing needed care.

With nearly 80 years of experience in group benefits management, MedBen specializes in saving clients money on even the costliest claims. Learn more about the ways we do it by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

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