WHY CHARON PLANNING
Case Studies: Vendor Management
A national manufacturer of commercial and residential
construction products
Our client was approaching their medical premium
settlement and the insurance company initially used their standard methodology for calculating
annual claim reserve requirements. Charon Planning challenged the carrier's standard calculations
and performed a claim reserve analysis based on a combination of current data and emerging experience.
As a result of Charon Planning's claim reserve analysis
and intervention with the carrier, the client saved nearly $500,000 on their annual medical premium
settlement.
A Mid-Atlantic supplier of commercial building materials
A client's employee sustained a catastrophic
injury resulting in huge medical claims under the client's self-funded plan. The client's
stop-loss carrier denied their portion of the claims on the grounds that care was not medically
necessary, leaving the client with a $250,000 liability. Charon planning extensively researched
the medical standards of care for the type of extreme injury, gathered/prepared supporting documentation
and appealed the stop loss carrier's decision.
Charon Planning's appeal efforts were successful,
resulting in the elimination of the client's $250,000 claim liability.
A Mid-Atlantic marketing organization
Our client's employee was being billed nearly
$7,000 for covered services by a healthcare provider. The healthcare provider was threatening
to turn the account over to collections. After confirming with the plan carrier that the
services were covered and payment had been sent, Charon Planning contacted the healthcare
provider on behalf of the client's employee to ensure the application of payment.
Charon Planning was able to gain acknowledgement
from the healthcare provider that the payment was received and secure confirmation that
the account was paid in full and that no collection action would be taken.
|
