Stop Loss Companies and Reinsurers Help Employers Tackle Key Challenges

The high cost of healthcare claims is just one of several market challenges facing self-insured employers today. The cost of preventable hospital-acquired conditions adds to those expenses, but as Jakki Lynch, Carbon Stop Loss Solutions’ Director of Cost Containment, explains in The Self-Insurer, plan sponsors can mitigate significant charges associated with these conditions with a comprehensive payment integrity program. 

For example, in a recent high dollar sepsis case reviewed by the Carbon payment integrity team, $255K (26%) of overall contract payable charges of $984K were identified as being incurred from preventable sepsis after cardiac surgery. Based upon the claim payment integrity review, the facility agreed these charges are not payable.

Read the full article here.