Regardless of whether an employee’s intent is to defraud their employer, or whether the employee simply does not understand the plan rules, the time to correct an eligibility error is before a major health issue arises.
The Post-ACA Era and Preparing for the UnknownHodges-Mace
The issues and priorities of carriers, employers, employees, brokers, and the government will dictate the evolution of health insurance as we transition into the post-ACA era. These insights tell us what to expect as the benefits landscape continues to evolve under President Trump.
The combination of the right strategy and smarter technologies can help you ensure employees are getting the most value out of their benefits package year-round, increasing their confidence and their satisfaction.
1) Workers' compensation claims have been declining for decades due to improved workplace safety and technology. However, illegitimate claims have risen among workers with high deductible health plans who misrepresent injuries.
2) Offering accident and disability insurance plans can reduce illegitimate workers' compensation claims by 46% on average. These voluntary benefits deter workers from falsely claiming injuries as work-related to avoid medical costs.
3) Employers with high deductible health plans are more likely to experience increased questionable workers' compensation claims. Offering accident or disability plans can help address this issue and improve risk management.
This document discusses how employers can use voluntary benefits as a creative risk management strategy to control costs and reduce workers' compensation claims. It states that offering voluntary accident and disability insurance can help decrease the frequency and expense of workers' compensation claims, with 40% of companies reporting declines in workers' comp claims from offering voluntary accident insurance and 36% reporting declines from voluntary disability insurance. The document advocates that incorporating voluntary benefits into an employee benefits package can help employers more effectively manage risks while providing employees with valuable financial protection.
These are the slides displayed during the September 28th webinar on Understanding the Importance of ACOs presented by ROI2 and hosted by Dr. Barry Mennen, MD. With Matt Eyles and Jim Smith.
Most employers are still learning about private exchanges, with over half being familiar but only 6.4% currently using them. The top perceived benefits are helping employees make more cost-conscious choices and offering a wider array of options. When setting up an exchange, employers want tools for plan comparison, online access, consolidated enrollment and billing. Attributes like COBRA compliance and carrier integration are also important. Most employers learn about exchanges from independent research, brokers and consultants rather than carriers or third-party administrators.
Will There Be a Productivity Revolution in Health Care? - David CutlerWSU
Health care is poised to undergo a revolution in productivity. With changes in organization and financing of care, we could improve productivity in medical practices, and for the system as a whole. The talk will describe how health care productivity can be increased, and the paths that might be taken with or without reform.
The Latest Healthcare Financial Trends: What You Need to KnowHealth Catalyst
As 2017 comes to an end, two of our most experienced and capable people are assessing this year’s most prominent healthcare financial trends and using those clues to better read the tea leaves to predict which trends will impact 2018. Tasked with delivering ground breaking financial software products, Dorian DiNardo, Senior Vice President, Analytics, daily has her finger to the wind to sense how shifting trends are impacting market needs. She will join Bobbi Brown, Senior Vice President, Professional Services, who will lead the webinar conversation. Bobbi has several impressive decades of experience in financial leadership for some of the most storied organizations including Intermountain, Sutter Health and Kaiser Permanente. Among other trends that popup in the next few weeks, she will examine three of 2017’s most significant healthcare trends:
Transitions in payment models
Healthcare market disruptions from well-known companies as well as some not-so-familiar newcomers
Emerging importance of technical data skillsets
The Post-ACA Era and Preparing for the UnknownHodges-Mace
The issues and priorities of carriers, employers, employees, brokers, and the government will dictate the evolution of health insurance as we transition into the post-ACA era. These insights tell us what to expect as the benefits landscape continues to evolve under President Trump.
The combination of the right strategy and smarter technologies can help you ensure employees are getting the most value out of their benefits package year-round, increasing their confidence and their satisfaction.
1) Workers' compensation claims have been declining for decades due to improved workplace safety and technology. However, illegitimate claims have risen among workers with high deductible health plans who misrepresent injuries.
2) Offering accident and disability insurance plans can reduce illegitimate workers' compensation claims by 46% on average. These voluntary benefits deter workers from falsely claiming injuries as work-related to avoid medical costs.
3) Employers with high deductible health plans are more likely to experience increased questionable workers' compensation claims. Offering accident or disability plans can help address this issue and improve risk management.
This document discusses how employers can use voluntary benefits as a creative risk management strategy to control costs and reduce workers' compensation claims. It states that offering voluntary accident and disability insurance can help decrease the frequency and expense of workers' compensation claims, with 40% of companies reporting declines in workers' comp claims from offering voluntary accident insurance and 36% reporting declines from voluntary disability insurance. The document advocates that incorporating voluntary benefits into an employee benefits package can help employers more effectively manage risks while providing employees with valuable financial protection.
These are the slides displayed during the September 28th webinar on Understanding the Importance of ACOs presented by ROI2 and hosted by Dr. Barry Mennen, MD. With Matt Eyles and Jim Smith.
Most employers are still learning about private exchanges, with over half being familiar but only 6.4% currently using them. The top perceived benefits are helping employees make more cost-conscious choices and offering a wider array of options. When setting up an exchange, employers want tools for plan comparison, online access, consolidated enrollment and billing. Attributes like COBRA compliance and carrier integration are also important. Most employers learn about exchanges from independent research, brokers and consultants rather than carriers or third-party administrators.
Will There Be a Productivity Revolution in Health Care? - David CutlerWSU
Health care is poised to undergo a revolution in productivity. With changes in organization and financing of care, we could improve productivity in medical practices, and for the system as a whole. The talk will describe how health care productivity can be increased, and the paths that might be taken with or without reform.
The Latest Healthcare Financial Trends: What You Need to KnowHealth Catalyst
As 2017 comes to an end, two of our most experienced and capable people are assessing this year’s most prominent healthcare financial trends and using those clues to better read the tea leaves to predict which trends will impact 2018. Tasked with delivering ground breaking financial software products, Dorian DiNardo, Senior Vice President, Analytics, daily has her finger to the wind to sense how shifting trends are impacting market needs. She will join Bobbi Brown, Senior Vice President, Professional Services, who will lead the webinar conversation. Bobbi has several impressive decades of experience in financial leadership for some of the most storied organizations including Intermountain, Sutter Health and Kaiser Permanente. Among other trends that popup in the next few weeks, she will examine three of 2017’s most significant healthcare trends:
Transitions in payment models
Healthcare market disruptions from well-known companies as well as some not-so-familiar newcomers
Emerging importance of technical data skillsets
The document discusses trends in employer-sponsored healthcare benefits for open enrollment season in 2015. It discusses how many employers are requiring employees to actively select benefits during open enrollment rather than defaulting to the previous year's selections. It also discusses the rise of consumer-driven health plans and health savings accounts/reimbursement arrangements, as well as the growing popularity of private health exchanges and wellness programs paired with financial incentives. Finally, it discusses how employers and others in healthcare are increasingly leveraging technology to streamline processes and communications.
With the launch of the public insurance exchanges in October 2013, and many other provisions of healthcare reform that took place on January 1, 2014, there are still several questions about ACA (Affordable Care Act) implementation and timing.
This timeline, compiled from the Kaiser Family Foundation's Ultimate ObamaCare Survival Guide, explains how and when the provisions of the health reform law will be implemented over the next several years.
What does the new Affordable Care Act mean to you? How are businesses and employees adapting to the timeline? Learn More from Healthcare Trends Institute.
The document summarizes survey results from the 2016 Aflac WorkForces Report on employee benefits trends. Key findings include:
- 14% of small businesses with under 50 employees offer high-deductible health plans over $1,000, while 19% offer wellness programs and 10% offer voluntary insurance.
- Common changes small businesses made to benefits in 2015 included increasing copays and premium shares, implementing high-deductible plans, and reducing plan options.
- When it comes to concerns, 40% of small businesses said staying competitive is most important while 38% cited lack of qualified talent.
Infographic 360 peo ACA Remains Law of the LandAlex Miller
While the Individual Mandate is no longer required the Employer Mandate is still required.
Until any legislation or regulations are formally enacted into law, the ACA remains the law of the land and all of its mandates, penalties, and enforcement remains in effect and your employer and individual clients should continue to follow all rules and regulations that are currently in place. Learn how a PEO is simplfying compliance, HR, benefuts, communications, payroll and technologies.
Midsized business owners face many challenges managing their businesses, including rising healthcare costs, complexity of regulations like the Affordable Care Act, and an increasing volume of government regulations. While concern over some issues has decreased slightly in recent years, confidence remains low, with many owners struggling to understand regulations and unsure of how to develop strategies to address challenges. Globalization is also affecting more midsized businesses, but few feel prepared to manage international operations or navigate varying international compliance rules. Overall, persistent issues are taking a toll on confidence levels among midsized business owners.
Compensation Management System for Health Care ProvidersCOREmatica
This document describes a compensation management system for health care providers that allows for performance-based compensation aligned with corporate strategies. It features a powerful calculation engine, objective metrics, and rules-based payments to motivate providers. The system aims to improve documentation, throughput, efficiency and revenue capture while reducing payroll errors and empowering providers.
Using Segmentation to Personalize Low-Income Program Outreach and Increase Pa...E Source Companies, LLC
We recently completed research into New England's low-income population. Read a summary of our findings and some suggested next steps for improving outreach efforts and boosting participation.
The document discusses injury and illness prevention programs (IIPPs), which are proactive processes that help employers identify and fix workplace hazards before workers get hurt. The key is management leadership, worker participation, hazard identification and control, training, and program evaluation. Studies show IIPPs can dramatically reduce injuries and illnesses, lower costs from insurance and lost productivity, and improve workplace culture. They are required in many countries and 34 US states due to their effectiveness.
Healthcare providers are ready and planning to assume increased levels of risk through commercial payer and Medicare contracting models and Medicare Advantage, according to a new Navigant analysis based on a survey conducted by HFMA.
Onboarding Compliance in the Healthcare Professional EnvironmentEquifax
Healthcare is easily one of the most tightly regulated industries in the US and without a targeted onboarding compliance strategy in place for your Health Care Professional hires (HCP), you could be exposing your organization to significant risks.
The document discusses the potential impact of 2010 health care reform on WellPoint, Inc., a major health insurance carrier. It outlines key provisions of the reform legislation, analyzes how different parts of WellPoint's business may be affected in terms of membership mix, costs and revenues. The document also reviews WellPoint's financial and enrollment data and considers options for marketing and distribution strategies in light of the regulatory changes.
Psychmentation is a business intelligence method that aims to overcome the limitations of traditional market research methods. It seeks to discover vital information not normally accessible about a customer's "true mind" through an emergent process using grounded theory techniques. Case studies are presented showing how Psychmentation identified unexpected customer insights that led organizations to make strategic changes, improve products, enhance their value proposition, validate programs, and optimize effectiveness, resulting in increased market share and competitive advantages.
Small business employees are more satisfied with their jobs than those at medium and large businesses, but are less satisfied with their benefits packages. Only 50% of small business employees are extremely or very satisfied with their benefits, compared to 59% at medium businesses and 60% at large businesses. Improving benefits was cited by 47% of small business employees as something their employer could do to keep them, higher than other size businesses. The report found that only 18% of small businesses offer voluntary insurance benefits to employees.
This document summarizes a study evaluating small group employer participation in New Mexico's State Coverage Insurance (SCI) program. The SCI program provides comprehensive health insurance to individuals and small businesses. The study found that administrative burden and costs were barriers to employer participation. Employers concerned about premium obligations and uncertainty about future costs chose not to participate. The study also found that most uninsured workers eligible for SCI worked for small businesses and had low incomes, indicating the need for premium subsidies. The Affordable Care Act's small business tax credits aim to address these issues but administrative requirements and time limits may still pose challenges to employer uptake.
More than 60% of providers struggle to derive optimal value from their EHRs and 85% believe consumer self-pay will continue to impact their organizations, according to an annual HFMA/Navigant survey of 108 provider CFOs and revenue cycle executives.
The survey found that:
1) Hospital executives predict more moderate growth in revenue cycle IT budgets and continue focusing technology investments on improving revenue integrity and addressing issues with EHRs and consumer self-pay.
2) Many providers struggle to optimize revenue cycle functions in their EHRs and are still challenged by the impact of EHR adoption on revenue cycle performance.
3) While providers have gotten better at managing consumer financial responsibility, it remains a significant issue, especially for health systems and large hospitals.
This document discusses 5 key areas for employers to consider when reviewing their workplace pension scheme after starting auto-enrollment. These include: 1) Ensuring accurate employee data and compliance processes; 2) Auditing pension records for accuracy; 3) Evaluating the time and resources required for administration; 4) Reviewing the selection of the pension scheme to ensure it is still appropriate; 5) Calculating the true ongoing costs of running the pension scheme versus outsourcing administration. Conducting this review will help employers ensure their scheme remains compliant and suitable for their business needs.
This document discusses 5 key areas for employers to consider when reviewing their workplace pension scheme after starting auto-enrollment. These include: 1) Ensuring accurate employee data and compliance processes; 2) Auditing pension records for accuracy; 3) Evaluating the time and resources required for administration; 4) Reviewing the selection of the pension scheme to ensure it is still appropriate; 5) Calculating the true ongoing costs of running the pension scheme versus outsourcing administration. Conducting this review will help employers ensure their scheme remains compliant and suitable for their business needs.
BIZGrowth Strategies - Workforce & Talent Optimization Special EditionCBIZ, Inc.
Amid today’s economic uncertainty, we know you need strategies and solutions that will help your business thrive. With workforce and talent concerns running high for employers across the nation, our experts developed these articles with those critical issues top of mind. We offer fresh insights designed to attract, retain, engage and motivate your employees — all while protecting your bottom line and managing emerging risks. Articles include:
- Unlock Success with Effective Performance Management
- How Employers Can Benefit from Financial Wellbeing Programs
- How to Talk About Hard Decisions During a Recession
- Cost-Effective Health Plan Perks to Consider in 2023
- 3 HR Strategies to Recession-Proof Your Organization
- Responding to Employment Practices Liability (EPL) Claims
- Versatility — Important in Life & Life Insurance
The document discusses trends in employer-sponsored healthcare benefits for open enrollment season in 2015. It discusses how many employers are requiring employees to actively select benefits during open enrollment rather than defaulting to the previous year's selections. It also discusses the rise of consumer-driven health plans and health savings accounts/reimbursement arrangements, as well as the growing popularity of private health exchanges and wellness programs paired with financial incentives. Finally, it discusses how employers and others in healthcare are increasingly leveraging technology to streamline processes and communications.
With the launch of the public insurance exchanges in October 2013, and many other provisions of healthcare reform that took place on January 1, 2014, there are still several questions about ACA (Affordable Care Act) implementation and timing.
This timeline, compiled from the Kaiser Family Foundation's Ultimate ObamaCare Survival Guide, explains how and when the provisions of the health reform law will be implemented over the next several years.
What does the new Affordable Care Act mean to you? How are businesses and employees adapting to the timeline? Learn More from Healthcare Trends Institute.
The document summarizes survey results from the 2016 Aflac WorkForces Report on employee benefits trends. Key findings include:
- 14% of small businesses with under 50 employees offer high-deductible health plans over $1,000, while 19% offer wellness programs and 10% offer voluntary insurance.
- Common changes small businesses made to benefits in 2015 included increasing copays and premium shares, implementing high-deductible plans, and reducing plan options.
- When it comes to concerns, 40% of small businesses said staying competitive is most important while 38% cited lack of qualified talent.
Infographic 360 peo ACA Remains Law of the LandAlex Miller
While the Individual Mandate is no longer required the Employer Mandate is still required.
Until any legislation or regulations are formally enacted into law, the ACA remains the law of the land and all of its mandates, penalties, and enforcement remains in effect and your employer and individual clients should continue to follow all rules and regulations that are currently in place. Learn how a PEO is simplfying compliance, HR, benefuts, communications, payroll and technologies.
Midsized business owners face many challenges managing their businesses, including rising healthcare costs, complexity of regulations like the Affordable Care Act, and an increasing volume of government regulations. While concern over some issues has decreased slightly in recent years, confidence remains low, with many owners struggling to understand regulations and unsure of how to develop strategies to address challenges. Globalization is also affecting more midsized businesses, but few feel prepared to manage international operations or navigate varying international compliance rules. Overall, persistent issues are taking a toll on confidence levels among midsized business owners.
Compensation Management System for Health Care ProvidersCOREmatica
This document describes a compensation management system for health care providers that allows for performance-based compensation aligned with corporate strategies. It features a powerful calculation engine, objective metrics, and rules-based payments to motivate providers. The system aims to improve documentation, throughput, efficiency and revenue capture while reducing payroll errors and empowering providers.
Using Segmentation to Personalize Low-Income Program Outreach and Increase Pa...E Source Companies, LLC
We recently completed research into New England's low-income population. Read a summary of our findings and some suggested next steps for improving outreach efforts and boosting participation.
The document discusses injury and illness prevention programs (IIPPs), which are proactive processes that help employers identify and fix workplace hazards before workers get hurt. The key is management leadership, worker participation, hazard identification and control, training, and program evaluation. Studies show IIPPs can dramatically reduce injuries and illnesses, lower costs from insurance and lost productivity, and improve workplace culture. They are required in many countries and 34 US states due to their effectiveness.
Healthcare providers are ready and planning to assume increased levels of risk through commercial payer and Medicare contracting models and Medicare Advantage, according to a new Navigant analysis based on a survey conducted by HFMA.
Onboarding Compliance in the Healthcare Professional EnvironmentEquifax
Healthcare is easily one of the most tightly regulated industries in the US and without a targeted onboarding compliance strategy in place for your Health Care Professional hires (HCP), you could be exposing your organization to significant risks.
The document discusses the potential impact of 2010 health care reform on WellPoint, Inc., a major health insurance carrier. It outlines key provisions of the reform legislation, analyzes how different parts of WellPoint's business may be affected in terms of membership mix, costs and revenues. The document also reviews WellPoint's financial and enrollment data and considers options for marketing and distribution strategies in light of the regulatory changes.
Psychmentation is a business intelligence method that aims to overcome the limitations of traditional market research methods. It seeks to discover vital information not normally accessible about a customer's "true mind" through an emergent process using grounded theory techniques. Case studies are presented showing how Psychmentation identified unexpected customer insights that led organizations to make strategic changes, improve products, enhance their value proposition, validate programs, and optimize effectiveness, resulting in increased market share and competitive advantages.
Small business employees are more satisfied with their jobs than those at medium and large businesses, but are less satisfied with their benefits packages. Only 50% of small business employees are extremely or very satisfied with their benefits, compared to 59% at medium businesses and 60% at large businesses. Improving benefits was cited by 47% of small business employees as something their employer could do to keep them, higher than other size businesses. The report found that only 18% of small businesses offer voluntary insurance benefits to employees.
This document summarizes a study evaluating small group employer participation in New Mexico's State Coverage Insurance (SCI) program. The SCI program provides comprehensive health insurance to individuals and small businesses. The study found that administrative burden and costs were barriers to employer participation. Employers concerned about premium obligations and uncertainty about future costs chose not to participate. The study also found that most uninsured workers eligible for SCI worked for small businesses and had low incomes, indicating the need for premium subsidies. The Affordable Care Act's small business tax credits aim to address these issues but administrative requirements and time limits may still pose challenges to employer uptake.
More than 60% of providers struggle to derive optimal value from their EHRs and 85% believe consumer self-pay will continue to impact their organizations, according to an annual HFMA/Navigant survey of 108 provider CFOs and revenue cycle executives.
The survey found that:
1) Hospital executives predict more moderate growth in revenue cycle IT budgets and continue focusing technology investments on improving revenue integrity and addressing issues with EHRs and consumer self-pay.
2) Many providers struggle to optimize revenue cycle functions in their EHRs and are still challenged by the impact of EHR adoption on revenue cycle performance.
3) While providers have gotten better at managing consumer financial responsibility, it remains a significant issue, especially for health systems and large hospitals.
This document discusses 5 key areas for employers to consider when reviewing their workplace pension scheme after starting auto-enrollment. These include: 1) Ensuring accurate employee data and compliance processes; 2) Auditing pension records for accuracy; 3) Evaluating the time and resources required for administration; 4) Reviewing the selection of the pension scheme to ensure it is still appropriate; 5) Calculating the true ongoing costs of running the pension scheme versus outsourcing administration. Conducting this review will help employers ensure their scheme remains compliant and suitable for their business needs.
This document discusses 5 key areas for employers to consider when reviewing their workplace pension scheme after starting auto-enrollment. These include: 1) Ensuring accurate employee data and compliance processes; 2) Auditing pension records for accuracy; 3) Evaluating the time and resources required for administration; 4) Reviewing the selection of the pension scheme to ensure it is still appropriate; 5) Calculating the true ongoing costs of running the pension scheme versus outsourcing administration. Conducting this review will help employers ensure their scheme remains compliant and suitable for their business needs.
BIZGrowth Strategies - Workforce & Talent Optimization Special EditionCBIZ, Inc.
Amid today’s economic uncertainty, we know you need strategies and solutions that will help your business thrive. With workforce and talent concerns running high for employers across the nation, our experts developed these articles with those critical issues top of mind. We offer fresh insights designed to attract, retain, engage and motivate your employees — all while protecting your bottom line and managing emerging risks. Articles include:
- Unlock Success with Effective Performance Management
- How Employers Can Benefit from Financial Wellbeing Programs
- How to Talk About Hard Decisions During a Recession
- Cost-Effective Health Plan Perks to Consider in 2023
- 3 HR Strategies to Recession-Proof Your Organization
- Responding to Employment Practices Liability (EPL) Claims
- Versatility — Important in Life & Life Insurance
How to Prevent Medical Billing Claim Denials?
MGSI provide best Anesthesia medical billing Services in united states. https://www.mgsionline.com/anesthesia-billing.html
This document discusses dependent eligibility audits, which involve third-party vendors verifying that dependents enrolled in an employer's health plan meet the plan's eligibility requirements. It covers:
1) Why employers conduct these audits, which is typically to identify ineligible dependents and save costs while preserving benefits.
2) The typical four stages of an audit: planning, verification where documentation is requested, a grace period, and follow through of removing ineligible dependents.
3) Key factors that impact the potential savings from an audit, such as industry, response rate, communications quality, and timeframe. On average, audits find 8% of dependents to be ineligible, saving $3,000
Instructions for assignment reflect on your professional experAssuser47f0be
The document provides instructions for an assignment asking the reader to reflect on their professional experiences with leaders and managers. It asks the reader to identify a leader from their experience that matches one of four descriptions: a good leader lacking management skills, a good manager lacking leadership skills, an effective leader and manager, or neither a good leader nor manager. For the identified leader, the reader is instructed to analyze the leader's strengths/weaknesses, impact on the business environment, and lessons learned about balancing leadership and management skills.
Clark Schaefer Hackett created this buyer’s guide to help you and other plan fiduciaries make an informed decision when hiring a quality auditor for your employee benefit plan audit. This guide covers your fiduciary responsibilities, the timing of a plan audit, audit quality, finding the right auditor and more.
Accountants Guide to Workers Compensation & Health BenefitsADP, LLC
Accountants, as trusted advisors, are often called upon to help small business clients figure out their insurance needs. Few accounting firms have a licensed insurance agent available — only 8% of survey respondents were licensed or had a licensed insurance agent in the firm. Review this guide to help you understand how you can help!
Process Improvement: A Consultant's View of your Healthcare Revenue Cycle | A...Meduit
Get a look at how well your revenue cycle processes are functioning and learn how to identify the initiatives your healthcare facility can take to reduce days in A/R and boost revenue! Download the live event recording here: https://lab.meduitrcm.com/process-improvement-innovationlab-webinar/
Revenue cycle management success: Learn these key factorsEyeCareLeaders1
Your ophthalmic practice should be leaning heavily on its revenue cycle management plan. RCM can help your practice minimize errors, increase the chances you will get paid, and tamp down on the size of your accounts receivable. https://eyecareleaders.com/revenue-cycle-management-success-factors/
HR compliance update is essential for keeping up with ever-changing laws and regulations. Start 2020 confident you can handle the questions from supervisors, employees, and corporate leaders about employment law changes.
Denial Management in Medical Billing.pdfalicecarlos1
Medical Billers and Coders (MBC) is a leading revenue cycle company providing complete medical billing services. Our medical specialty-wise RCM experts ensure all the denied claims are addressed properly to receive accurate insurance collections.
Here are the key points I would reflect on from this case:
- Maintaining integrity and independence is important as an auditor, even when under budget pressure. Falsifying time spent on audit procedures violates accounting standards and ethics.
- Learning to manage expectations and communicate issues with the engagement team is an important skill. Being transparent about delays outside of my control allows for informed decision making.
- Understanding motivations and pressures at different levels (e.g. manager's promotion review) provides context, but cannot justify compromising audit quality or standards.
- Gaining experience and trusting my own judgment, while also seeking advice from more experienced team members. Knowing when "stuff happens all the time" is acceptable versus a red
Chapter 6 – Controlling Accounts ReceivablesQuestion 1. Are cr.docxchristinemaritza
Chapter 6 – Controlling Accounts Receivables
Question 1. Are credit checks performed before terms are granted to customers? Describe the process.
Conducting credit checks is highly recommended prior to setting terms granted to customers. In this way, the business owner would be able to prevent bad debts that would affect the company’s financial status.
To do so, the business must run a credit check on customers. Some private institutions provide credit services wherein they run background checks on individuals. The business may opt to charge customers with a credit check fee and then have them fill in forms where the customers consent to having a credit check run. After the results of the credit check, the business may then decide whether to transact with a customer. If they agree to a transaction, the business sets the terms depending on the customer’s credit background, particularly his or her ability to pay for rendered products or services.
Question 2. What type of sale agreements do you have in place, which are signed before the sales takes place?
Prior to signing the contract, agreements during sales include policies on return and exchange, the purchase price, the description of the product or goods being sold, warranties, description of how the goods will be delivered, and other notes agreed upon by the buyer and the seller.
Question 3. What is your Accounts Receivables turnover?
The Accounts Receivables turnover must be high for the business to ensure that it does not incur bad debts.
Question 4. What is the procedure to receive payments from customers including the receiving of the mail, opening the mail, recording the transactions, and making deposits into the bank?
To receive payments from customers including the receiving of the mail, opening the mail, recording transactions, and making deposits into the bank, the business owner should have initially recorded the terms of the receivable during the time of sale. After receiving and opening the mail, the transactions must be recorded using invoices. After keeping track of the flow of cash through invoicing, the receivables may be forwarded to the auditors and accountant. The business owner would then make a decision on how it would be deposited in the company’s bank.
Question 5. Describe the procedure the company follows when receiving payments from customers. What documents are verified to insure payments match the invoice sent to customers?
When receiving payments from customers, the business verifies the term of receivables agreed upon between the business owner and the customer. To insure payments match the invoice sent to customers, records such as the aging schedule and the general journal may be used to check the invoice using the records.
Question 6. Is there an aging process for all Accounts Receivables accounts to better control receipts from customers and to collect from overdue accounts?
Establishing and maintaining in aging process for all Acc ...
The audit cycle performance consists of planning, preliminary survey, understanding the entity, identifying key areas and objectives, determining audit criteria, collecting evidence, generating working papers, and preparing audit findings. The initial stages involve obtaining general information on the company and identifying important areas to focus on. Later stages are testing evidence, documenting results, and communicating findings to the audited entity in a clear and understandable manner.
eBook: Key Factors when Evaluating Outsource Medical BillingMichelle Harper
When evaluating potential outsource billing partners, agencies should consider 7 key factors:
1. Define your specific billing needs to identify suitable partners.
2. Check partners' experience, particularly with your industry and payors.
3. Evaluate if partners can meet your defined needs and address issues like software compatibility.
4. Consider pricing models like per patient, percentage, or per claim rates.
5. Review contract terms regarding costs, length, renewals and other fees.
Taking time to evaluate potential partners across these factors helps identify the best fit.
The document provides guidance for plan sponsors on hiring an auditor for an employee benefit plan audit. It outlines fiduciary responsibilities for plan sponsors, when an audit is required, and the importance of hiring a quality auditor. A quality auditor can help identify errors, ensure compliance, and provide ongoing guidance and solutions to benefit the plan. The document recommends plan sponsors consider an auditor's experience level, team orientation, and ongoing involvement when selecting one.
Adam Gobin presented on Emory Healthcare's denial management process. They applied management engineering techniques like DMAIC to streamline denial workflows through hyper-specialization and centralization. Key steps included defining denial categories, measuring trends through reports, analyzing patterns, improving through standardized workflows, and controlling quality. This led to significant improvements such as reduced write-offs, registration denials, and medical record requests as well as increased payments for aged claims. Lessons included planning resources, stakeholder buy-in, and using standardized reporting for accountability.
Acct 504 mart perfect education acct504mart.comstudent234511
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Case Study 1 (Part A)Analyze the impact of business transactions on accounts; record (journalize and post) transactions in the books; construct and use a trial balance) For Discussion Question 1: Post your response to the following:
• When reviewing a financial report, why should information be reliable, relevant, consistent, and comparable?
• In other words, why are these accounting characteristics important?
• What kinds of problems could be created if a financial report is not reliable, relevant, consistent, or comparable?
Similar to Dependent Verification: What You Don't Know Can Hurt You (20)
Your Guide To Finding The Perfect Part-Time JobSnapJob
Part-time workers account for a significant part of the workforce, including individuals of all ages. A lot of industries hire part-time workers in different capacities, including temporary or seasonal openings, ranging from managerial to entry-level positions. However, many people still doubt taking on these roles and wonder how a temporary part-time job can help them achieve their long-term goals.
How to Leverage AI to Boost Employee Wellness - Lydia Di Francesco - SocialHR...SocialHRCamp
Speaker: Lydia Di Francesco
In this workshop, participants will delve into the realm of AI and its profound potential to revolutionize employee wellness initiatives. From stress management to fostering work-life harmony, AI offers a myriad of innovative tools and strategies that can significantly enhance the wellbeing of employees in any organization. Attendees will learn how to effectively leverage AI technologies to cultivate a healthier, happier, and more productive workforce. Whether it's utilizing AI-powered chatbots for mental health support, implementing data analytics to identify internal, systemic risk factors, or deploying personalized wellness apps, this workshop will equip participants with actionable insights and best practices to harness the power of AI for boosting employee wellness. Join us and discover how AI can be a strategic partner towards a culture of wellbeing and resilience in the workplace.
Watch this expert-led webinar to learn effective tactics that high-volume hiring teams can use right now to attract top talent into their pipeline faster.
Start Smart: Learning the Ropes of AI for HR - Celine Maasland - SocialHRCamp...SocialHRCamp
Speaker: Celine Maasland
In this session, we’ll demystify the process of integrating artificial intelligence into everyday HR tasks. This presentation will guide HR professionals through the initial steps of identifying AI opportunities, choosing the right tools, and effectively implementing technology to streamline operations. Additionally, we’ll delve into the specialized skill of prompt engineering, demonstrating how to craft precise prompts to enhance interactions between AI systems and employees. Whether you’re new to AI or looking to refine some of your existing strategies, this session will equip you with the knowledge and tools to harness AI’s potential in transforming HR functions.
Becoming Relentlessly Human-Centred in an AI World - Erin Patchell - SocialHR...SocialHRCamp
Speaker: Erin Patchell
Imagine a world where the needs, experiences, and well-being of people— employees and customers — are the focus of integrating technology into our businesses. As HR professionals, what tools exist to leverage AI and technology as a force for both people and profit? How do we influence a culture that takes a human-centred lens?
The Rules Do Apply: Navigating HR ComplianceAggregage
https://www.humanresourcestoday.com/frs/26903483/the-rules-do-apply--navigating-hr-compliance
HR Compliance is like a giant game of whack-a-mole. Once you think your company is compliant with all policies and procedures documented and in place, there’s a new or amended law, regulation, or final rule that pops up landing you back at ‘start.’ There are shifts, interpretations, and balancing acts to understanding compliance changes. Keeping up is not easy and it’s very time consuming.
This is a particular pain point for small HR departments, or HR departments of 1, that lack compliance teams and in-house labor attorneys. So, what do you do?
The goal of this webinar is to make you smarter in knowing what you should be focused on and the questions you should be asking. It will also provide you with resources for making compliance more manageable.
Objectives:
• Understand the regulatory landscape, including labor laws at the local, state, and federal levels
• Best practices for developing, implementing, and maintaining effective compliance programs
• Resources and strategies for staying informed about changes to labor laws, regulations, and compliance requirements
Building Meaningful Talent Communities with AI - Heather Pysklywec - SocialHR...SocialHRCamp
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Digital transformation has transformed the talent acquisition landscape over the past ten years. Now, with the introduction of artificial intelligence, HR professionals are faced with a new suite of tools to choose from. The question remains, where to start, what to be aware of, and what tools will complement the talent acquisition strategy of the organization? This session will give a summary of helpful AI tools in the industry, explain how they can fit into existing systems, and encourage attendees to explore if AI tools can improve their process.
AI Considerations in HR Governance - Shahzad Khan - SocialHRCamp Ottawa 2024SocialHRCamp
Speaker: Shahzad Khan
This session on "AI Considerations in Human Resources Governance" explores the integration of Artificial Intelligence (AI) into HR practices, examining its history, current applications, and the governance issues it raises. A framework to view Government in modern organizations is provided, along with the transformation and key considerations associated with each element of this framework, drawing lessons from other AI projects to illustrate these aspects. We then dive into AI's use in resume screening, talent acquisition, employee retention, and predictive analytics for workforce management. Highlighting modern governance challenges, it addresses AI's impact on the gig economy as well as DEI. We then conclude with future trends in AI for HR, offering strategic recommendations for incorporating AI in HR governance.
Accelerating AI Integration with Collaborative Learning - Kinga Petrovai - So...SocialHRCamp
Speaker: Kinga Petrovai
You have the new AI tools, but how can you help your team use them to their full potential? As technology is changing daily, it’s hard to learn and keep up with the latest developments. Help your team amplify their learning with a new collaborative learning approach called the Learning Hive.
This session outlines the Learning Hive approach that sets up collaborations that foster great learning without the need for L&D to produce content. The Learning Hive enables effective knowledge sharing where employees learn from each other and apply this learning to their work, all while building stronger community bonds. This approach amplifies the impact of other learning resources and fosters a culture of continuous learning within the organization.
2. We’ll briefly cover the basics of a
dependent verification review and then do a
deeper discussion on why it’s an important
tactic for businesses today
Today’s Webinar
Overview
01. What is a Dependent
Verification Review?
02. Who Should Consider a
Verification Review?
03. Ineligibles: How Does it Happen?
04. Best Practices
05. Case Studies
3. Meet Mark
3
Who is Mark Helton?
Mark is responsible for dependent verification strategic initiatives
for Hodges-Mace clients and brokers. He spent the first 25 years
of his career in HR management, and has 8 additional years
experience specializing in dependent review process design,
implementation, and management.
: markhelton@hodgesmace.com
Areas of Expertise
Human Resources Management
Dependent Verification Strategy
Dependent Review Project Management
Dependent Verification Consulting
5. What it is vs. What it’s not
When people hear the term “audit,” it brings to mind something bad that could happen to your tax return. In truth, a
dependent audit is a preventive measure that helps you assess the accuracy of your dependent enrollments.
IT IS IT IS NOT
Protection for employees
A review confirms that the people an employee is
responsible for covering won’t run into financial and
legal problems down the road.
Added peace of mind
It’s an opportunity to confirm that people who are
important to the employee are covered and protected.
A way to true up plan participants
A review seeks to confirm who should be on the
plan according to the rules of the plan.
A fishing expedition
It is not meant to identify people who are using the plan
in the way it is meant to be used.
Punishment / accusation
A dependent audit only aims to ensure people who are on
the plan are legal able to take advantage of the benefits.
A way to exclude eligible individuals
Audited employees have the opportunity to
correct any missing or incorrect documentation.
6. Why it Matters
A dependent verification review provides confirmation that the employer is
being a good steward of both the employee’s and the employer’s
healthcare dollars.
Company Employee
8. Should you consider a
dependent
review?
8
A dependent review may be
worthwhile if your company is large
enough that HR does not know:
>500
An organization over 500
employees on a health care plan is
a prime candidate to participate in
a review.
5%-12%
In general, 5%-12% of dependents
on health care plans are ineligible.
$250,000
These numbers reflect an average
of $250,000 savings per 1,000
dependents enrolled.
Each employee and their family status
The family members of each employee
Who of those family members are allowed
to be on a health care plan
10. Let’s Look at a Few Scenarios
10
SCENARIO 1: Not Understanding the Plan’s Rules
• Following a divorce a court order is issued for an employee
to pay for coverage for the former spouse for the next two
years.
• What the employee does not realize is the court order states
the employee must pay for the coverage – the court can’t
order the employer to pay for the coverage and in fact that
person is no longer eligible. Likewise, former stepchildren are
no longer eligible.
SCENARIO 2: Rising healthcare costs
• As healthcare costs continue to strain family budgets,
employees are seeking ways to reduce their financial burden.
• Employees may add ineligible relatives or friends to their plan
in exchange for monetary compensation, effectively giving
themselves a discount.
While this is a common practice with shared
services like mobile phones, sharing one’s benefits
with people who are not eligible poses a financial
risk to everyone involved.
In trying to do the right thing, the employee is
unwittingly including ineligible dependents on
their employer’s plan. This exposes them and the
company to undue financial risk.
11. An oil and drilling company has an employee with an ineligible
dependent on the plan.
That dependent incurs a $250,000 claim, which the company
pays. When the company files a claim for reinsurance, it is
denied.
Time for a poll: What would you do?
A Real Life
Example
Sue the Employee for Payment
The company could sue for payment of the
claim, but doing so would severely harm
employee relations and perception.
Pay the $250,000 and Hopefully No More
The company could pay the initial claim, and
hope that the dependent does not incur
additional expenses.
Pay the $250,000 and Then Some
The company could pay the $250,000 and still be
on the hook for any additional expenses
associated with the original claim.
A
B
C
Take the Poll
12. Here’s What
Happened
The employer felt a lawsuit would be financial damaging; they
had not set any precedent around dependent eligibility.
The PR nightmare was too daunting to be worth the risk.
In the end, the employer paid costs for the claim and may be
on the hook for future costs associated with the claim.Pay the $250,000 and Then Some
The company could pay the $250,000 and still be
on the hook for any additional expenses
associated with the original claim.
C
14. 14
Best Time
To Conduct a Review
While every business has a different busy season, there is one hard and fast
rule around the best time to conduct a dependent review.
At the same time as
Annual Enrollment
Second or third quarter
after Annual Enrollment
First quarter following
Annual Enrollment
15. Typical Review Timeline
The dependent verification review process should have three components.
15
Planning Phase – 4 weeks
Verification Phase – 6 weeks
Grace Period – 4 weeks
16. Ongoing Review Process
Many employers choose to perform maintenance reviews of new dependents on an ongoing basis.
This process prevents re-accumulation of ineligible dependents on the plan.
16
01.
Start with a clean
population
02.
New hires or mid-year life
events take place
03.
Mini-audit cycles are
conducted on newly added
dependents
05.
Selective audits conducted
on changing populations
04.
Exception reporting used to
identify potentially ineligible
dependents
18. Best Practices
18
Communications
Include a well planned communication process,
including an announcement, reminders, and email and
phone assistance for employee questions and clear
timelines for completion.
Returned Mail and Cleanup
Have a well-defined process for tracking and following
up on returned mail to ensure that employees receive
proper notifications and other communications.
Documentation Guidelines
Clearly communicate examples of acceptable
documentation that employees are required to
submit.
19. Best Practices
19
Accessibility
Account for various ways for employees to submit
documentation. (e.g., fax, web portal upload, email,
smartphone photo, USPS, etc.)
Process Monitoring
Include access to real-time portals for project
tracking for both the employee and the HR team.
Project Management
Best-in-class dependent verification reviews will
include regular follow-up intervals to provide HR
with updates on project progress.
20. CASE STUDIES:
A quick look at a
few client success
stories
05
PART
S a v i n g s v i e w e d a s r e d u c e d
a d m i n i s t r a t i v e c o s t s a n d
d e c r e a s e d e x p o s u r e t o
h e a l t h p l a n
21. Industrial Drilling
21
Dependents enrolled in
medical coverage with
the company
530
$412,000in first
year savings
$412kPercent of
dependents found to
be ineligible – or
103 total
20%
CASE STUDY
22. Auto Manufacturing
22
Dependents enrolled in
medical coverage with
the company
3,098
$1,130,000 in first
year savings
$1.13MPercent of
dependents found to
be ineligible – or
260 total
8.4%
CASE STUDY
23. Healthcare Provider Initial Review
23
Dependents enrolled in
medical coverage with
the company
12,000
$3,200,000 in first
year savings
$3.2MPercent of
dependents found to
be ineligible – or
1,000 total
8.3%
CASE STUDY
First review was conducted in 2012
24. Healthcare Provider Second Review
24
Dependents enrolled in
medical coverage with
the company
6,187
$2,200,000 in
additional
savings
$2.2MPercent of
dependents found to
be ineligible – or
689 total
11.1%
CASE STUDY
Second review took place in 2016
26. Frequently Asked Questions
26
Question 1
How do we prepare the employees for
upcoming review?
Question 2
What are some best practices for preparing
executive expectations?
Question 3
Should I do this myself or should I hire a service?
Question 4
What are the benefits of having an
ongoing review process?
Question 5
How are past claims handled?
Question 6
How should we handle late submissions?
Question 7
When are ineligibles removed from the plan?
Question 8
Is there any risk to ineligibles misusing the
plan leading up to removal?