Beware of the Fine Print

Beware of the Fine Print

There’s a troubling trend among large administrators to prevent plan sponsors from effectively auditing their claims adjudication. Unfortunately, audits are one of only a few ways employers can hold TPAs and PBMs accountable for applying reasonable claim controls. After all, if they win new business by having broad networks, lower discounts, and lower fees, the easiest way to prop up that facade is to automatically pay almost every claim submitted by providers. (more…)

Mental Health First Aid

Mental Health First Aid

The pandemic has disrupted work, family, and social routines, causing a rise in anxiety, depression, substance abuse, and other behavioral health issues like never before. That’s why we were so pleased to recently sponsor a Mental Health First Aid course for a group of our clients and roundtable members. (more…)