• Dependent Eligibility Audits

    Employers regularly find that between 4% and 8% of employees have an ineligible dependent on the company health plan. HMS can identify and help permanently remove ineligible dependents to generate immediate and sustainable savings.

  • Claim Audits

    HMS’s robust technology is capable of filtering large volumes of claims to identify more than 100 common processing errors. Our audits help prevent future errors and enable plans to recover incorrectly paid claim dollars.

    Transitional Reinsurance

    In 2014, HHS will require fully insured and self-funded plans to pay an annual Transitional Reinsurance fee of $63 fee per each covered life enrolled in major medical coverage.