Recent content by tfgpartners

When large employers self-fund their health plans and outsource the claim administration, oversight becomes essential. Medical claims auditing, and a similar review of pharmacy claims, is the best way to double-check. Third-party administrators and pharmacy benefit managers promise low error...

The coronavirus pandemic turned things upside down financially for many health plans, with increased utilization and astronomical costs for some treatments. In its wake, medical claims audits are one of the ways plans have conducted post-mortems on their experience. The impact of a...