At USBenefits, your goal is our goal – to provide the best possible outcome for the employer. This is not just a tagline for the employees at USBenefits, but a drive to do everything we can to support our customers.
We work closely with our Third-Party Administrators (TPA)/producers from the time of the initial request for a quote, through the application process and implementation of the policy.
At USBenefits, we believe communication is the key to getting an account implemented seamlessly. We are more than willing to work with our producers to help them walk through the stop-loss process with their clients. Our underwriting team has over 30 years’ experience, so who better to help your client through the stop-loss process?
Once a new account is sold with USBenefits, our claim team will take it from there and meet with the TPA operations staff to show them how to file claims and notices. With the many years we’ve been in business, there is nothing under the sun we have not seen.
With the high cost of healthcare, it’s critical the TPA and stop-loss claims team work together to ensure they are minimizing the claim expense for our mutual clients. USBenefits will take the lead on those high-cost claims that may exceed the Plan’s specific deductible. USBenefits has a team of claim review vendors that have been vetted over many years to ensure they are the best in the business. Working with our vendors, USBenefits has saved our clients almost $6 million in just the last 18 months.
Below are a few examples of how the USBenefits claims team has impacted our clients.
- A Plan was charged almost $900,000 for two air ambulance claims. USBenefits had one of our vendors review the claim and it was determined that the claims were not medically necessary so the claim was denied by the TPA.
- Another Plan had a claim with billed charges over $3,000,000. USBenefits got involved and sent the claim to our ERISA attorney and it was determined that the claim should be denied based on the illegal acts provision.
- A TPA contacted USBenefits to let us know that they had a claimant that was suffering from COVID and was transferred to an out of network hospital. The USBenefits claim staff took it from there and identified a vendor that has extensive experience negotiating with providers. The vendor had the hospital cost data so when they contacted the hospital it didn’t take long for the hospital to agree to a 56% discount off billed charges which resulted in over $2,200,000 savings for the Plan.
At USBenefits, we understand the importance of keeping the Plan claim expense low which will keep their renewal rates reasonable and help to retain the client not only for USB, but for the TPA/producer as well. At USBenefits we pride ourselves on taking care of you so that you can take care of your business.
