Implementation Audits
Confirm your healthcare plan is set up correctly from the start.
What is an implementation audit?
An implementation audit on a healthcare benefits plan verifies that the plan administrator understands the plan language, has programmed the system according to plan intent, and is set up to pay claims correctly from the beginning.
This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is a language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed.
What’s at stake?
Avoiding these risks is crucial and easy with BMI Audit Services.
Needed
Language for this is needed. Language for this is needed.
Needed
Language for this is needed. Language for this is needed.
Needed
Language for this is needed. Language for this is needed.
Needed
Language for this is needed. Language for this is needed.
Needed
Language for this is needed. Language for this is needed.
Needed
Language for this is needed. Language for this is needed.
This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed.
“Our implementation audit with BMI was a huge success! The client had an extremely customized benefit plan and BMI was able to accommodate all of our asks and more. They were easy to work with and provided an excellent report of their findings, which they reviewed in detail with us. We were able to get many of the kinks worked out before they actually happened.
Highly recommend! ”
It’s easy to work with us
How does it work?
We make it easy.
This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed.
Because we do the hard work, you can be as hands-off or involved as you want. Our clients report they spend an average of _______ on project-related activities. Here’s what to expect:
1. Planning + Setup
Planning a dependent verification audit starts with defining which dependents need to be verified and what documents are required. BMI then helps to establish a timeline, communication plan, and secure ways for members to submit documents. Systems and processes are put in place to ensure a smooth and efficient audit.
what you do
Share eligibility rules
Participate in a kick-off call with BMI experts
Send enrollment file to BMI
Approve communication templates
Announce the verification internally to members
What we do
Assign a project manager to be your designated consultant and guide throughout the project
Analyze eligibility rules
Create a timeline using key dates received from client
Conduct a kick-off call with the plan sponsor and/or the broker consultant to review project timing, communication plan and confirm document requirements
Configure BMI’s software according to client eligibility criteria
Verify enrollment file for accuracy and completeness
Import and process the enrollment file in accordance with the project requirements
Tailor communications to the specifics of the campaign
Train BMI call center and document processing teams on specific eligibility rules and documents being requested
Grant access to and provide a demo of BMI’s Verification Portal and dashboard reporting
2. Communicate + Verify
Once the dependent verification effort has been communicated to members, BMI collects and reviews documentation submitted by members for authenticity and compliance with the plan’s eligibility rules. If more information is needed, members receive follow-up communications with additional instructions.
What you do
Monitor progress and review updates
Refer member questions to BMI
Provide updated addresses for returned communications
Give feedback to BMI on unique member scenarios
Participate in a status call with the BMI team
What we do
Send the audit notification to all members included in the enrollment file with instructions on how to complete the verification process and what documents are needed
Provide live human support to members needing assistance through our US-based, multilingual in-house call center, or by email
Give each member access to BMI Verify to submit documents, view their current status in the process, and complete the verification form
Review each document received from members to verify accuracy and ensure it meets your eligibility requirements
Request additional information from members who:
submit partial responses
have not responded
Conduct a status call with the plan sponsor and/or the broker consultant to review progress, explain reporting, and discuss what to expect for the remainder of the project
3. Reporting + Results
BMI keeps you informed throughout the verification process, making it easy to see who is eligible and ineligible. The insights gained from the dependent audit help organizations improve benefits administration, control costs, and establish guidelines for future ongoing verification.
What you do
Participate in a wrap-up call with BMI experts
Send termination letters using a template provided by BMI
Remove ineligible dependents from coverage
What we do
Provide clients with 24/7 access to progress reports through our online dashboard. The dashboard will be available throughout the entire project and includes information such as:
Progress towards completion
Family and dependent status
Ineligible and incomplete reasons
Alerts
Compile verified results, flag ineligible dependents, and provide a final detailed report to the employer for action
Conduct a wrap-up call to review the final results and consult with the client on how to move forward with next steps for the removal of ineligible dependents
Deliver an Executive Report including statistics and summarization of the final results, return on investment, and recommendations for future verification
Types of Implementation Audits
This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed
Pre
This is language that needs to be developed. This is language that needs to be developed.
Post
This is language that needs to be developed. This is language that needs to be developed.
This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed. This is language that needs to be developed.