eNewsletter: Building the Business Case

• Healthcare Cost Savings Achieved through Dependent Eligibility Audit
  
  
• First Steps in Reducing Health Plan Costs
  
  
• What Can Go Wrong and Disrupt Audit Results
  
  
• Eligibility Controls, How Did We Get Here?
  
  
• Healthcare Cost Savings Case Study: Dependent Eligibility Audit Results

eNewsletter: Evaluating Your Dependent Eligibility Alternatives

• Evaluating Dependent Eligibility Audit Alternatives
  
  
• Promise Versus Proof Approach to Dependent Eligibility

Download your Dependent Eligibility Audit Evaluation Resources (Individual PDFs):

• Vendor Qualifications for Dependent Eligibility Audit
  
  
• Evaluating Dependent Eligibility Audit
  
  
• Building the Business Case
  
  
• Comprehensive Dependent Eligibility Audit

View Dependent Eligibility Audit results by industry.

Do you have effective quality controls for your health plan(s) dependent eligibility? 

Health plan enrollment has lacked any meaningful Internal Controls for decades. For instance, enrollment forms have not changed much since the 70s. Moving enrollment to the Web simply compounds the problem. This outdated process was designed to facilitate gaining coverage through an employee signature, but paper and web forms fails to verify the eligibility of dependents.  

The fact is that most providers don’t have the infrastructure, systems, or incentives to ensure quality control.

In order to have effective controls you need:

1. A comprehensive evidence based verification process; and
2. A Gate Keeper solution that takes ongoing events such as hires, fires, promotions, weddings, divorces, COBRA, etc. into account and manages eligible dependents.