Out-of-network charges run amok

JGI found in a recent audit that our client’s TPA was paying significantly more for out-of-network claims than the plan’s benefit allowed. The TPA was running claims through a rental network, usually for small percentage...
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In 2015, JGI was proud to donate a portion of our revenues to Siloam Family Health Center and Faith Family Medical Center. We set a goal from the founding of our company to give annually...
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Evaluating Claims Audit Vendors

Shopping for a claims audit is difficult, given the limited exposure to claims audits topics for most employers. Some common issues to pursue in evaluating proposals include: What is the scope of your auditing process?...
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Why Do I Need a Claims Audit?

The healthcare industry is a sloppy one and costs are constantly on the rise. Industry studies show that overpayments are 1-3% of total expenses, not including fraud. Self-insured employer healthcare plans are complicated. They often...
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Core Values: Flexibility

Companies often are simply hard to deal with. Accountability and decision-making are spread thin, requirements are set that are difficult to understand, and then legal gets involved on top of that. At J. Graham Inc.,...
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