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).
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.
Thorough Claim Review Leads to At-Home Treatment Solution that Saves Nearly $100K Per Year for Individual Member
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 [...]
Forward-Thinking Employee Benefits Lead to More than $2 Million in Savings and Healthy Outcomes for Plan Members
When offering health benefits to employees, employers face the risk of experiencing high-cost claims if plan participants are diagnosed with a serious illness or disease. Self-funding allows the flexibility to plan for these situations … proactively. In this example, Tom [...]
TPA Controls High Claimant Costs through Claims Management, Early Detection
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 [...]
How Self-Funded Employers Are Saving Up to 30% with Reference-Based Pricing
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 [...]