USBenefits not only has over 35 years of experience in claim payment and review, but also the expertise and contacts to help TPAs and Plan sponsors navigate what can be a very complicated industry.
Below is a recent success story achieved by our claims team.
A TPA alerted USBenefits of an accident claim with over $3 million in billed charges. At the time, the TPA was reviewing the claim and reached out to USBenefits for assistance with how to proceed – considering we work closely with one of the top ERISA attorneys in the stop loss industry.
Since the claim had yet to be submitted to USBenefits, we connected the TPA to our ERISA attorney so they could collaborate on how to handle the claim. After close review of the plan document with the TPA and the Plan, the attorney advised that the claim should be denied based on an illegal acts provision in the Plan.
Not only did the plan save a substantial amount of money, but they now have access to a top attorney to help them on any future ERISA issues. Does your stop-loss partner have the expertise and contacts that will ultimately save you money?
