finHealth Solutions

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HR
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insurers
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providers
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shared-services

Human Resources

Robust health & wellness benefits are critical to attracting and retaining top talent for your organization. However, healthcare is costly, incredibly complex to manage, is undergoing radical change in terms of service delivery, and a significant portion of the costs are rapidly shifting to the employee.

Per the Center for Medicare & Medicaid Services, healthcare costs on average are expected to rise at nearly 6% per year for at least the next 10 years. How can your organization promote healthy outcomes for your people, while also keeping your corporate costs in line for your stakeholders?

 

Knowledge is power when it comes to managing and controlling healthcare cost. finHealth Navigator delivers the insight to keep costs in line, while also using your data to foster employee wellness and educate them on the value and expertise of their chosen medical providers.

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Finance/Audit

Healthcare is the second largest “people” cost behind salaries, the fastest growing expense of any kind in a large organization (at three times the rate of inflation over the last 10 years), and one of the last remaining expense areas with little to no financial governance. While many folks might assume that their third party administrator (TPA) delivers rigorous controls and audit oversight to this area, they are not financially aligned to do so. Clearly, these TPA’s have edits & validations in place to flag errors at the point of payment. However, every dollar that the third party invests in retrospectively auditing paid claims represents one less dollar in profit for them, and subjects the TPA to greater scrutiny as any errors flagged happened on their watch (essentially “airing their dirty laundry”). Here’s the perspective of one the major bill payers on the risks and inequities in the claim payment process:

Blue Cross Blue Shield Knee Hip Surgery Rates Vary Widely

 

If an organization with the resources and deep expertise of Blue Cross Blue Shield struggles to keep healthcare costs in line, how can your organization keep these rapidly escalating expenditures in check? The answer may lie with finHealth Navigator, offering education on critical healthcare issues, full cost transparency, valuable peer benchmarks to see how you stack up and proprietary scoring algorithms to flag claims that were paid incorrectly.

Knowledge is power when it comes to negotiating contracts with providers/carriers, spotting financial errors that have occurred in the process, reducing utilization of high cost services through employee communication and understanding the dynamics to promote healthy outcomes for employees and a more fit, engaged workforce.

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Health Systems

Do you have a good handle on your overall billing practices? Do you have high rates of claim denial from your providers? Is it unclear why your claims are being refused? Have you been subjected to a RAC audit yet?

finHealth Navigator offers unparalleled access to your billed claims, and identifies issues before you are hit with the embarrassment, reputational damage, legal costs and often stiff fines associated with billing your patients incorrectly.

 

Let finHealth be your trusted advocate to ensure your organization is in full compliance with proper medical coding practices.

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Global/Shared Services

Healthcare cost control is a potential new frontier for shared services, whether those costs are controlled by HR, Finance or Global Business Services. With rapidly escalating costs, high error rates and very poor financial alignment with your third party administrator, healthcare costs are badly in need of tighter scrutiny.

If an organization with the resources and deep expertise of Blue Cross Blue Shield struggles to keep healthcare costs in line, how can our organization keep these rapidly escalating expenditures in check? The answer may lie with finHealth Navigator, offering education on critical healthcare issues, full cost transparency, valuable peer benchmarks to see how we stack up and proprietary scoring algorithms to flag claims that were paid incorrectly.

 

Knowledge is power when it comes to negotiating with providers/carriers, identifying specific medical procedures to be carved out for more advantageous pricing, understanding diseases/conditions that might be impacting our workforce or reducing utilization of high cost services like emergency room visits.

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