Union Trust

Health Decisions is aware of and equipped to deal with the special relationship Union Trusts have with union membership. We are experienced in working with electrical workers (IBEW), plumbers, carpenters, pipefitters, steelworkers, and painters unions to assure effective health insurance plan administration as a means of maximizing benefits for members. Our successful experience in helping multiemployers and Taft-Hartley funds administer health plans has resulted in significant cost savings and improved practices to assure continued cost containment.

A Dependent Eligibility Audit is an especially effective tool for helping union trusts manage their rising health care costs. Health Decisions’ proven approach to dependent verification results in a high response rate and a strong ROI, without any appeals or other negative member relations issues.

Additionally, Health Decisions offers the most comprehensive and sophisticated Medical Claims Audit service in the industry. Nobody addresses more areas of claim recovery or recovers more money per client than we do. In addition, we will develop customized recovery applications requested by the Fund at no additional cost.

Health Decisions goes much deeper seeking claims to recover by conducting a review of 100 percent of claims in more than 30 areas, to identify and recover claims paid that are not the Union Trusts’ responsibility. None of the recoveries come from individual members but rather are collected from other health plans, insurance companies, providers, and enforcement of judicial orders.

Because Health Decisions is at the cutting edge of technology we can help Taft-Hartley and other multiemployer plans better deal with:

  • Keeping enrollment and eligibility information current and correct
  • The fallout of automated adjudication of claims
  • Fraud and abuse detection and prevention
  • Medicare recovery
  • Identifying the best Continuous Quality Improvement (CQI) solution
  • Satisfying HIPAA and other regulatory requirements

Health Decisions’ proprietary claims review system includes an emphasis on span of control, financial return, staffing, implementation, and CQI. Our suite of services covers data handling, data processing, case investigation, and case updates.

Health Decisions accepts claims and enrollment data in almost any format and provides it to our Union Trust clients in Microsoft and web-compatible formats.

All of our services allow Health and Welfare Plans to document in a tangible manner their fiduciary responsibilities and provides a means for employers to satisfy HIPAA requirements.

Do you have Questions? We have answers! Click Here to contact us!

“[The Health Decisions Audit Team] does a great job – they’re very diligent and work hard looking under every stone for potential recoveries. Knowing the claims payers are processing claims properly is very important for our Trustees and Fiduciaries. When claims payers have to deal with organizations like Health Decisions, it keeps them on their toes!”


Tom Mittelbrun III
Administrator
Electrical Workers Insurance Fund

Check out the latest episode in our "Prudence Says" video series:

 
409 Plymouth Road, Suite 220 • Plymouth, Michigan 48170
phone 734­.451.2230 • fax 734­.451.2835
© 2011 - 2024 Health Decisions, Inc.