One thing that’s often a real difference maker for self-funded clients is the emphasis that’s placed on health claim review. As third party administrator (TPA) MedBen noted in a recent blog post, the savings opportunities identified can be quite substantial – even on an individual basis. The TPA shares a case study that shows how its combination of claims technology and professional analysis by medical specialists uncovered a situation where a plan member was paying nearly $172,000 annually for an injectable drug to treat a chronic illness. After flagging and further investigating the health claim, MedBen’s team came up with a cost-savings solution that allows the plan member to save more than $24,000 per dose, which adds up to nearly $100,000 each year. It involves partnering with a specialty pharmacy and educating the member to successfully transition to self-injection. This is just one example of the savings that can result from the more comprehensive approach to claims review with self-funding.

[Original case study on MedBen’s blog]

For more information or to contact MedBen, visit or call (740) 522-8425.