The Brilliant Broker: Healthcare Audits for Benefit Consultants

Healthcare claim audits benefit many different types of businesses and their bottom lines. Here at CTI, we continue to service clients ranging all the way from the largest of Fortune 100 companies to smaller municipalities with our industry leading healthcare claims audits. But, that’s not all. We also produce beneficial results for another niche in the insurance industry that often overlooks the positives that completing an audit can provide, the independent healthcare benefit consultant. In this blog post, we’ll briefly take a look at some of the drivers behind why benefit consultants should recommend a healthcare claims audit of their client.


In today’s internet driven, social media-savvy world, reputations can travel like lightning. By recommending an audit of the TPA you have chosen for your client’s plan administration, you will show your client that you have their best interests at hand by going the extra mile. Why not shine that spotlight on yourself and stand out from the agents that simply allow their clients to spend considerable amounts of money without verifying if it’s spent correctly? By hiring an audit firm, your client will be holding their TPA to the same standard that they hold you to.


When you prove to your clients that you are constantly thinking of effective methods to help contain costs, potential new clients won’t be able to help but notice that you are differentiating yourself when it comes to keeping premiums at the level they should be.  


If an audit shows that problems stem from the lax administration of benefit requirements and restrictions, you have the opportunity to provide different services and vendors.  This is yet another opportunity to position yourself differently from your current competition.


Some benefit consultants allow themselves to get caught up by focusing on provider discount amounts only when selecting their claim administrator. This is somewhat similar to the unknowing consumer who gets fooled by the Black Friday discounts. By completing an audit, you’ll be the savvy shopper and will be better able to monitor bottom-line costs to the plan and the accuracy of its administration.


By completing an audit and analyzing the findings and trends that it produces, you will be able to improve your RFP questionnaire while reinforcing to your clients that you’ll continue to make the best recommendations.

In today’s age of ever-increasing healthcare costs, it’s clear to see that claim audits should be something that insurance agents, brokers and benefit consultants should consider adding to their arsenal. Not only are audits bottom-line boosters for your clients’ businesses, but they are also boosters for your own business, too.

To read more on how benefit consultants can stand out from the pack with CTI’s industry-leading healthcare audit services please click on the graphic below. If you’d like someone at CTI to reach out to you, please contact us here.


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