TFG Partners – White Paper Summary
This white paper argues that for large, self-insured companies, checking 100% of their healthcare claims for errors is far better than the traditional method of checking just a random sample.
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It’s never been a better time to audit your Pharmacy Benefit Manager (PBM) and the claim payments it makes on your plan’s behalf. With drug price increases expected in 2023 for commercial and employer-sponsored health plans, keeping an eye on things will be vital. CONTINUE READING
When large and medium-size employers weigh the value of medical claims auditing and continuous claims monitoring service, we remind our clients there are added values to consider.
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The medical plan audits and continuous monitoring we provide at TFG Partners are expected to benefit from the Federal Hospital Price Transparency Rule that took effect on January 1, 2021. It requires hospitals to post prices online for 300 services, including MRIs, heart procedures and surgeries, joint replacements, new patient visits, and lab tests. CONTINUE READING
Can Merged Companies Better Reduce Health Costs?
Each year in the United States, health care costs increase. It’s something we watch every day at TFG Partners as we conduct medical claim audits. Rising costs are a budget issue for businesses, the government, and all of us as individuals. Therefore, the search is always on for ways to reduce costs. In the past couple of years, combining health and pharmacy benefit administrators was heralded as a way to do it. Yet a survey of corporate benefits executives found that only 50-percent had confidence it would work. The rationale from the combined companies is that cost-savings result when fewer entities are trying to earn a profit. CONTINUE READING