A 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.
Read MoreThis client’s employee benefits broker approached BMI for reassurance of proper plan adjudication after their third-party administrator reimbursed the group for errant claim payments.
Read MoreA small employer group with 259 employees covering 600 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 MoreAt the recommendation of their consultant following concerns about the accuracy of claims adjudication, this employer group approached BMI to conduct an audit of medical and prescription drug claims paid by their third-party administrator.
Read MoreFollowing successful claims audits conducted with this organization’s affiliate, this small manufacturer approached BMI to help confirm if enrolled dependents actually met the organization’s self-funded medical plan eligibility requirements.
Read MoreIn support of due diligence efforts, a construction industry health and welfare fund approached BMI to conduct a comprehensive audit of 24 months of medical claims paid by their third-party administrator.
Read MoreThis city and county government approached BMI to help confirm if health care plan dollars were being spent appropriately by verifying the eligibility of 7,596 enrolled dependents.
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