? A "YES" to one or more of the questions indicates it's time to audit your Administrator. BENEFITS OF AN AUDIT In addition to saving your plan money by finding costly repetitive... payment errors, the ICAPS audit has other benefits... It tells you about the administration of your present plan: Do current systems effectively administer your plan? What areas... YOUR PLAN NEED A CLAIM AUDIT? To find out if your plan needs a claim audit, try asking yourself these questions... Is our program being administered as effectively as possible? If...

. Ms. Clark provides the following services to her clients... Statistical sampling of claim experience Benefit plan booklet and communication review Development of plan specific... agreements, electronic audits or audit findings Plan design and benefit philosophy consulting Prior to founding ICAPS, Ms. Clark held various positions in third party paying and billing... evaluation services for self-funded and self-administered health, dental, and disability plans. She has built a team of audit professionals and a long list of satisfied repeat clients...

throughout the United States... Review of plan documents and summary plan descriptions (SPDs) Preparation of summaries and/or flowcharts of plan specifications Auditing of claims... knowledge in employee benefits at two major insurance companies. For ten years, she was a health, life, and long term disability examiner, trainer, internal claims auditor.../Communications from the University of Minnesota, Minneapolis campus. She is a member of the International Foundation of Employee Benefits and the Midwest Fraud Association. She has...

, Dental and Disability Plans Carve out benefit plans such as Pharmacy and Mental Health PPO, Point of Service and HMO Plans Internal Audit Programs Providers Recovery Audits... OUR SERVICES ICAPS SERVICES: AUDITS ICAPS designs and conducts audits of... Self-Funded Health, Dental and Disability Plans (Pre- and Post-Implementation) Self-Administered Health... where problems exist and recommend solutions. The audit will assure you that the plan dollars issued are for eligible participants for services which were medically necessary...

a statistically valid stratified random sample of paid claims to review eligibility, Coordination of Benefits, subrogation, plan provisions, pricing, and re-adjudication... of the payment. REPORTICAPS provides you a thorough report on the findings of the audit. Recommendations, when necessary, are made for improvements: plan design, claims processing..., administrative procedure and policy. FOLLOW-UPAt the client's request, ICAPS will return to monitor the effectiveness of any changes to the administration of the employer's plan due...