Healthcare Horizons

Savings for self-insured employers & their employees! Claims audits identify & return overpayments.


What is Healthcare Horizons?

Healthcare Horizons has one focus, to audit the paid medical claims of self-insured employers' health plans. Our top priority is protect our client's financial interest by ensuring that their health plan claims are paid accurately. Many large employers self-insure their employee's medical expenses in order to contain healthcare costs. And they have a third party administrator, or TPA, manage the claims processing. However, one of the unintended consequences of self-insuring is that the TPAs don't have a financial incentive to control the employer's costs since they are using the employer's money and not their own. This can lead to processing mistakes. Annual healthcare claims audits can help keep the medical expenses in check and make sure that the employers are not overpaying claims or paying claims in error. And if they did overpay, we help recover the money.

How is Healthcare Horizons different?

We provide superior healthcare claims audit services utilizing our 100% different approach. This approach combines proprietary data analytics, a vast wealth of industry specific knowledge and exceptional expertise developed through years of working with extremely large claims data sets to review a hundred percent of our claims. Not only does our audit process ensure our clients are meeting their fiduciary responsibility, it also ensures that their employees are not negatively impacted by overpaying their deductibles and their co-insurance amounts. After the audit, the TPAs are then able to recover the identified overpayments for our clients and correct any root cause issues which improves efficiency and generates long term savings for our clients. Over three decades, we have worked with every national payer in the country and have recovered millions of dollars for our clients.

Who is a good fit for Healthcare Horizons?

Our client base consists of self-insured employers of various sizes. Healthcare Horizons serves self-insured employers with 2000 employees up to employers with more than a million employees. We provide audit services to public companies, privately held companies, state and local government entities and national laboratories. We have served clients in all types of industries including banking, financial healthcare, retail, technology, insurance and automotive. Any larger company or organization that puts their money on the line to fund healthcare plans is a perfect client.

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Duration: 02:40

Posted: Wednesday, July 20, 2022

Video tags: 501 - 1000 EEs, 1001 - 2500 EEs, 2501 - 5000 EEs, Over 5000 EEs