US Beacon ensures accurate and fair pricing for client’s health plans and their providers resulting in significant lower overall healthcare spend for the plans and members prior to actual payment of the claims/bills. US Beacon is a proven leader providing clients with a complete menu of cost containment solutions through a unique business model by utilizing a combination of artificial intelligence and hands on human review.
US Beacon provides clients with a complete menu of cost containment solutions through a unique business model by utilizing a combination of artificial intelligence and hands on human review.
Overview of US Beacon
US Beacon (USB) conducts compliance analysis review of medical claims for corporate and government health care and workers compensation plans. The compliance review identifies ineligible charges along with fraud, waste and abuse issues that the plan’s TPA and/or carriers miss. The results save plans millions of dollars and provides employees with a better health benefit at a much lower cost. On average, USB finds over 30% ineligible claims and savings on 99% of the claims we review. The effect to the total healthcare spends average 6% to 10% savings. USB provides the plan's trustees and administrators with transparency and control of their healthcare expenditures.
Benefits of US Beacon
- Mitigate liability for health plan managers, trustees and administrators: ERISA is a federal law that sets standards for non-government private health plans to protect individuals participating in these plans (employees/members). Plan managers, trustees and administrators have the fiduciary responsibility, obligation and liability to protect their members regardless of what their third-party payers do. Employees, former employees and stockholders can and do sue health plan administrators, managers and trustees for breach of fiduciary duty. US Beacon works for the managers, trustee, administrators and employees/members to conduct compliance analysis review of medical claims $10,000 or higher. The compliance analysis review helps protect government and private plan administrators, managers and trustees from being accused of not protecting their employees and breach of fiduciary duty.
- Monitor TPAs and Payers: The US Beacon compliance analysis review on behalf of the members, trustees, administrators and managers of the plan helps ensure that payers and TPAs are transparent and provide services that benefit the plan.
- Ensures accurate and fair pricing for our client’s health plans and their providers resulting in significantly lower overall healthcare spend for the plans and members prior to actual payment of the claims/bills.
- US Beacon has become an intricate part of providing proven solutions for lowering client healthcare spend. For more than 30 years USB’s principals have provided our clients and the healthcare arena with savings on medical claims and bills.
- Easy to integrate with any plan’s current payer or TPA. Most importantly, USB will be working independently for our clients, the health plan, and their members by performing an independent third-party review and analysis of all our clients claims/bills, thus providing a substantial incremental saving and a new revenue stream.
Who We Serve
- Corporate and Government Self-Insured Health and Workers Compensation Plans
- Insurance Companies
- Municipal Leagues
- Schools Districts
- Health Systems