Since its founding in 1992, HDM has always been a client-driven company. In fact, when we became the first to model the Administrative Services Only (ASO) and Summary Plan Description (SPD) that was a direct response to our clients asking for a more complete way of monitoring administrator compliance with a retrospective audit.

In 2008, we again polled our clients for their thoughts on what was lacking in health plan auditing today. The response was resounding, and unanimous: plan sponsors, particularly CFO’s, want total control over their self-insured plans. They want the sea of data they receive from administrators and other sources to be analyzed and turned into actionable information.

So HDM developed BenefitsWatch with this client feedback in mind.

BenefitsWatch begins with a download of claim data from our client’s administrator to form a baseline audit. After that the administrator provides us with a monthly data feed, enabling us to analyze and report on the three critical areas of health plan performance – compliance, budget and cost and utilization – quarter-to-quarter.

No other company in our industry can do that. Better yet, we analyze claim-by-claim, no matter how small the claim, uncovering far greater waste and fraud than is possible with an audit relying on a stratified sample.

BenefitsWatch requires that we audit both medical/dental and Rx claims because only that way can we pick up situations like extensive usage of an expensive drug by a plan member who was not diagnosed with the condition the drug is intended to treat.

BenefitsWatch gives you total control of your health plan, so you can’t be blindsided by the lack of discount oversight that surprised the State of Maryland. The services can also help you keep your reserve in line with today’s rising claim cost, and catch all the code, unbundling and other errors and the outright fraud that can strain your company’s budget.

For more information about BenefitsWatch and a downloadable brochure click here.