Health Insurance Mindset Shift #4

Welcome back to striking out the status quo, where your health plan is just one mindset shift away from greatness. Alright, here we are, part four of the Mindset Shift series. Today we're talking about auto adjudication. Imagine one of your sales reps takes a client out for a steak dinner. The next morning he submits a bill for reimbursement and your finance team just gives him the money right away without even looking at the bill. And then you look at the bill and here's what you see. You see a charge from the chef, a charge from the waiter, and something called a restaurant fee. And you learn that that steakhouse charges 500% more for steak than any other joint in town because, well, not really that good at making steaks. How angry would you be at your finance team for reimbursing that bill right away? This is what happens when your medical and pharmacy claims are auto adjudicated by your insurance company. They're not even looking at the bill, they're just paying the claim. So here's the mindset shift I want you to make. The higher the auto adjudication of your medical and pharmacy claims, the more mistakes and errors that are being paid for by your insurance company and the more money that's going out of your plan that is complete waste. So the next time you have a conversation with your broker or your insurance company about auto adjudication of claims, make sure you ask how much of your claims are being auto adjudicated. And just know, the higher the number, the more waste that's being paid for inside your medical plan. Until next time, bear down, focus on the target and strike out the status quo.