When preparing for next year's health plan budgeting, medical claim audits are essential to consider. They provides a detailed and factual report, showing what to expect. While most claims are processed accurately, errors can occur and are costly. When auditors review claims, it leads to corrections and recoveries. This information is valuable for forecasting expenses and budgeting for the future. It's also wise to communicate areas of interest to auditors in advance. It allows for a customized audit and provides an understanding for budget forecasting -- staying on top of costs is crucial when they’re rising.

Real-time claim payment monitoring through auditing services is trending. This continuous monitoring provides valuable insights and allows for prompt action on any issues. Employers should also allocate equal audit emphasis on pharmacy benefit plans, which can lead to significant savings. Reviewing name-brand products being incorrectly dispensed when lower-cost generics are available is essential. Keeping this information up to date is vital for effective budget planning. Employer-funded health plans rely on third-party administrators and pharmacy benefit managers to process thousands of claims. 

When 100 percent of claims are reviewed for the factors you're interested in, you'll have a clear picture for budgeting. It can also inform plan provisions that you may choose to update or at least revisit annually. Staying on top of costs always helps. Continuous monitoring by keeping audit systems running at all times is one of the most effective plan management tactics available. As the plan sponsor, you can expect monthly reports from your audit firm summarizing their findings. Imagine how much more efficient it is to recover overpayments the month after they are made rather than long in arrears.

It's also good to catch repeating errors and make system fixes because they add to million-dollar problems. Many employers wisely place equal audit emphasis on their pharmacy benefit plans. With the skyrocketing costs of medicines, the expenses are high, and the opportunities for savings are significant. It takes a specific audit setup for pharmacy plans, and claims auditors have the expertise. If it's been a while since you've audited your plan's claims, make a point to schedule a comprehensive claim review today. More up-to-date information is always helpful for your budget planning, short and long-term.