EBP2215. Health and Welfare Claims Testing

This session will focus on key aspects of what is involved with detailed claims testing in a health and welfare plan environment. This session will be especially helpful for those auditors who do not have an in-house claims testing expert available to deploy to test the adjudication of claims to help support the audit opinion of a health and welfare plan. Documentation best practices will also be discussed, including data retention and other important HIPAA considerations.

Learning Objectives:

• Reconstruct an understanding regarding what is involved in the detailed testing of health and welfare claims when an in-house claims testing expert is not available
• Assess best practices for handling PII and PHI during a health and welfare plan claims audit.