To ensure the accuracy of claims payments compared against their plan design, and to identify any other opportunities for cost containment, this large manufacturing and service provider engaged BMI to audit medical claims paid by their third-party administrator (“TPA”).
Read MoreAfter merging two companies into one benefit plan offering, this food and beverage company engaged BMI to verify whether 329 enrolled dependents were eligible for the company’s health plans.
Read MoreA large manufacturer engaged BMI to audit medical claims paid by their third-party administrator (“TPA”) after concerns were raised about whether certain claims were being paid appropriately.
Read MoreThis healthcare organization relied on BMI for ongoing dependent eligibility audits to help manage eligibility and spousal surcharge verification in circumstances such as life events or new hires. This independent expert verification can prevent ineligible dependents from continuing to enroll in the plan while reducing an employer’s administrative burden.
An initial audit by BMI led to the removal of over 1,000 dependents and annual savings of over 4 million dollars.
Read MoreA not-for-profit health system engaged BMI to audit medical claims paid by their third-party administrator (“TPA”) to demonstrate fiduciary responsibility over the plan’s administration to ensure benefits were being paid appropriately on behalf of plan participants.
Read MoreTo help combat rising health insurance costs, the internal audit department of a global engineering and manufacturing company engaged BMI to verify whether 511 enrolled dependents were eligible for the company’s medical and dental health plans.
Read MoreA client within the financial services industry approached BMI to conduct a pre-implementation audit after moving to a new carrier. Their primary objective was to verify whether the carrier’s system was set up appropriately to administrate their claims according to plan benefits.
Read MoreTo help combat rising health insurance costs, this electric motor manufacturer and their employee benefits broker engaged BMI to verify whether 3,425 enrolled dependents were eligible for health plan benefits.
Read MoreThis large county government engages BMI to conduct annual pharmaceutical claims audits of their self-insured pharmaceutical plan and pharmacy benefit manager (PBM). In addition, the client also engaged BMI to conduct a contractual financial guarantee audit.
Read MoreFollowing an initial audit, many clients rely on BMI for ongoing dependent eligibility audits. Circumstances such as life events, new hires, open enrollment or acquisitions combined with an employer’s limited internal resources, are often a driving factor to continue to utilize our expertise to ensure ineligible dependents don’t continue to remain on the plan.
Read MoreA nationally recognized mobile application developer engaged BMI to audit medical claims paid by their third-party administrator (“TPA”) after moving to self-insured and making several plan design changes.
Read MoreA healthcare organization with 4,908 employees engaged BMI to verify whether any of the 10,006 enrolled dependents met the plan’s eligibility and spousal surcharge criteria.
Read MoreA leading global medical technology company engaged BMI to audit medical claims paid by their third-party administrator as part of their due diligence efforts.
Read MoreWith over 1,300 dependent eligibility verification audits conducted for employers since 2003, it’s not uncommon to uncover findings like these:
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This global research and manufacturing organization engaged BMI to audit medical claims paid by their third-party administrator to ensure claims were being processed correctly for plan participants.
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A health and welfare fund with 636 members covering 1,421 dependents engaged BMI to verify the eligibility of all enrolled dependents to determine if they were eligible to receive health benefits.
Read MoreThis organization engages BMI to conduct annual audits of medical claims paid by their third-party administrator to ensure claims are continuing to be paid correctly following their last audit.
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An employer group with 910 employees covering 2,377 dependents contacted BMI to: 1) verify the eligibility of all dependents and 2) determine whether or not enrolled spouses should be paying a spousal surcharge per the plan.
Read MoreEvery few years this industrial sector employer relies on BMI to conduct a thorough review of medical claims paid by their third-party administrator to ensure benefits are being paid appropriately.
Read MoreTo help combat rising health insurance costs, this food manufacturer and their employee benefit broker engaged BMI to verify whether or not the 1,475 enrolled dependents were eligible for health plan benefits.
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