Appleton, WI (PRWEB) November 19, 2013
Known for his expertise in the self-funded industry, Tom Doney, president of Wisconsin-based Cypress Benefit Administrators, recently presented about ways employers can successfully contain employee benefit costs at a national HR conference.
Doney led the workshop “Are You Getting Ripped Off? Employee Benefit Best Practices” at Northwest Human Resource Management Association’s 75th annual event in Tacoma, Washington – an educational conference with over 700 business professionals in attendance.
He addressed the current state of health benefits and the fact that as plan costs continue to rise each year, so too do the amount of medical billing inaccuracies.
In his presentation, Doney addressed several points Cypress focuses on – and employers and HR staff need to be aware of – when managing self-funded employee benefits and controlling the associated costs.
Health claim review and management was a main emphasis as Doney referenced the American Medical Association’s 2012 National Health Insurer Report Card and shared that there is a 1 in 5 error rate among the seven largest U.S. health insurance companies. He underscored the importance of scrutinizing health claims for services or supplies that were never provided, the misrepresentation of procedures, unbundled or upcoded charges and much more.
According to Doney, upcharging is among the most costly problems that exist today. He said, “In one example, we reviewed various implant procedures – cardiovascular to orthopedic – and compared the total implant invoice amount to the total implant bill. Those numbers showed upcharges of an alarming 450 to 650%.”
Medical necessity is another area the Cypress team examines as Doney’s workshop included cases where patients were charged for services that weren’t deemed medically necessary once records were analyzed by peer independent reviewers. He explained, “In 2003, 12% of hospitals were billing the revenue code used for spinal trays. Now, just 10 years later, more than 90% of hospitals are billing for them.”
Another thing Doney stressed employers and HR pros should be diligent about is monitoring the costs of the latest treatment options. He shared how dialysis expenses keep climbing and the fact that plan language, at-home treatments and negotiated EPOGEN® drug discounts could offset these escalating charges.
Doney said the workshop was an eye-opening experience for many participants. “Employers are often surprised by all the ways they could be losing money through their health benefits.” He added, “At Cypress, we aim to educate people about these issues and help them take steps toward containing costs.”
A privately held company headquartered in Appleton, Wis., Cypress Benefit Administrators has been pioneering the way toward cost containment in self-funded health benefits since 2000. The third party administrator (TPA) is the country’s first to bring claims administration, consumer driven health plans and proven cost control measures together into one package for companies ranging from 50 employees to thousands of employees. It serves employer-clients across the U.S. with additional locations in Portland and Salem, Ore., Omaha, Neb. and Colorado Springs, Col. For more information on Cypress and its customized employee benefits, visit http://www.cypressbenefit.com.
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