Full-Service Medical Benefits Auditing of Plans
We Pioneered the Full-Service Approach and Lead the Industry in ROI.
Why Full-Service Benefit Claims Auditing?
At TFG, we pioneered the full-service approach and regard health benefits plan audits as a starting point. Our full-service, cost savings method adds analysis, advice, recovery, and advocacy to what is traditionally considered an audit. The result is a budget-neutral audit with efficiencies and savings that extend for years to come. We deliver a substantially higher return on your audit investment. When you add on continuous claims monitoring, we keep your plan fine-tuned in real-time to assure peak performance.
TFG Partners Can Improve Your Plan’s Performance in Ways that Help Employees and Your Bottom Line.
We’re Advocates, Ready to Put Audit Results to Use Immediately
- TFG works directly with benefits administrators on behalf of clients. We’ve worked with all of them.
- We are independent and 100-percent committed to helping identify and implement best practices.
- Our benefits audits help companies define and address problems, no matter where they exist in the system.
TFG Partners serves many Fortune 500 corporations, as well as many medium to smaller companies.
Benefits Claim Audits with the Industry’s Highest ROI
What happens when your medical claims auditor is also your advocate? Your plan performs the way it’s supposed to — employees are well served and costs are managed. Since our founding, TFG Partners has been dedicated to the ideals of caring for employees better while saving companies money. To us, it always has made sense to add value as we work so that our services are revenue neutral. As a top medical auditing claims company, we provide the industry’s best ROI and work hard to keep it that way.
In the beginning, we were a rarity in providing full-service benefits auditing with a multi-pronged approach. Since then, others have expanded their services. Many are the same ones that used to provide basic audits with no follow-up or advocacy. If imitation is the sincerest form of flattery, we feel flattered — but at the same TFG remains ahead of the pack and no one can compete with our ROI.
Step #1: Reviewing Plan Benefits
- Intensive plan document review
- Confirm the intent of benefits
- Clarification of benefits not defined
- Review of administrator-imposed audit and recovery limitations
- Customization of specific benefits plan design
- Support for additional custom review needs, by request
Step #2: Audit and Analysis
- More accurate and actionable audit results
- A comprehensive overview of all potential overpayments, regardless of a plan’s attributes
- Deeper insight into why errors have occurred and what will prevent them in the future
- Objective and fact-based assessment of administrator performance
- Meticulous and tactful assistance in bringing about process improvements
Step #3: Advice
- Better, more accurate claims adjudication
- Detailed compliance with ERISA and Sarbanes-Oxley
- Systematic/plan-wide error prevention
Step #4: Recovery
- We have facilitated the recovery of many millions of dollars
- The dollars are refunded directly to our clients’ plans
Follow a Medical Benefits Audit with Continuous Monitoring
Your self-funded health plan can maximize the financial management and member service value of our medical claim auditing with continuous monitoring service. It runs on the same powerful, proprietary TFG benefits auditing software and is the ideal follow-on to an audit. Just like audits that support overpayment recovery in medical billing, continuous monitoring service keeps your plan well managed. It flags mistakes in near real-time and helps ensure error patterns are flagged before they multiply to significant problems. Every year, more self-funded plans sign up and add a valuable layer of oversight.
It’s tough to find a medical claim auditor or medical benefits auditing company to match us for accuracy and thoroughness. We have pioneered and perfected many of the industry’s best practices. When a healthcare claims audit and the monitoring that follows it review 100-percent of claims, you’ll receive the industry’s most thorough and actionable reporting. Large and mid-size employers of all types, both corporate and nonprofit, benefit from our service, and we’ll help improve your bottom line while you serve plan members better. When it comes to healthcare benefits administration auditing, we are the innovator and industry leader.
