Self-Funding in Action

Claims Cost Control

A TPA’s Approach to Careful Claim Review

One of the biggest benefits employers report about their self-funded plans is the opportunity for cost savings through health claims. Learn how independent third party administrators (TPAs) approach the claims review process and help their clients save money through careful analysis.

For a full listing of all articles and topics featured, visit our Self-Funding in Action Archive page. Or feel free to browse other topics by clicking on any of the categories to the right (or below if on a mobile device).

Thank you for visiting! This website was only recently launched, so there will be more articles to come in the near future. Please stop back or bookmark this page … we will be updating content on an ongoing basis as TPAs share their stories related to self-funding success.

TPA Controls High Claimant Costs through Claims Management, Early Detection

Mar 17, 2017|0 Comments

A study shows that claimants who accumulate $50,000 or more in annual benefit costs represent nearly a third of total spending as it relates to employers’ health plans. What can be done to help contain these high costs? Third party READ MORE>

How Self-Funded Employers Are Saving Up to 30% with Reference-Based Pricing

Jul 28, 2016|0 Comments

Searching for a solution that would offset fast-rising healthcare costs and provide more savings than a traditional PPO discount, Custom Design Benefits introduced a reference-based pricing (RBP) program for its self-funded plans that is returning great results. When compared to READ MORE>

Self-Funding: Actual Cost Savings vs. Perceived

Dec 30, 2015|0 Comments

Working in third party administration for nearly 25 years, Caroline Fraker of MedBen has seen some of the more dubious methods like “guaranteed discounts” associated with traditional health plans. She explains how self-funding offers actual savings versus perceived. As the READ MORE>

$6.4 Million in Savings Realized Through Careful Claim Review

Dec 22, 2015|0 Comments

In a self-funded health plan, employers cover claim costs as they’re incurred, so keeping those charges in check is a top priority. Tom Doney of Cypress Benefit Administrators shares how this careful claim review is paying off in the form READ MORE>