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More Than Just an Audit

Updated: Dec 24, 2022

With uncertain economic times ahead, many companies are cutting back.

A recent Forbes article by Deborah Lovich, however, suggests a different approach to sustainability. The author contends that those companies that use this time to build and innovate are the ones that will prosper in the long run. Innovation is key and companies are realizing running their benefits department similar to any other part of their business can be an opportunity.

Lovich further suggests that rethinking now might be the best time to increase investment in talent. She calls it “creating talent advantage.” I can relate to the analogy used in the article regarding late Formula One racing great Ayrton Senna, winner of 41 Grand Prix races and three world championships, who famously said, “You cannot overtake 15 cars in sunny weather… but you can when it is raining.”

4C Digital Health helps companies improve by leaps and bounds through enhancing their benefit offerings without increasing cost. If you are thinking about using your benefits package to help build your talent advantage, our data platform, 4C Symphony, can assist. 4C can offer you an unparalleled advantage by providing powerful insights into your healthcare data. When competing in the marketplace, what would a healthcare plan that costs 8% to 12% less than your competitors mean to your employees? Those savings could translate into improved benefit offerings or making your compensation programs more valuable because of an increase in EPS with higher payouts.

Are you still playing the old audit game? The one where you only look at 250 claims (which is not a statistically valid sample) and only focus on carrier processing mistakes that don’t result in any money back. Our system can track 100% of your medical claim data through our proprietary reconciliation process to make sure you are only paying for what you received.

Another way to get ahead of competition is to have the insight into what your data is really saying. You no longer have to be dependent on firms that are not aligned with your interests. Ayrton Senna would never allow a competing team to tell him how he was performing, why should you?

Why is 4C Symphony Much More Than Just an Audit?

With 4C Symphony, you get a one-of-a-kind data platform for health plan benefit administrators to implement and manage a digital strategy. The platform includes a comprehensive and fully integrated array of analytics, data management, and collaboration tools that empower you to reduce costs and improve outcomes.

A common oversight opportunity of many self-insured employers surrounds contracted healthcare point solutions to improve the health outcomes and reduce cost in areas targeted for specific best-in-class care.

A question we often receive is “how do I really know if they are working when I am dependent on either the point solution or the carrier to tell me?” Self-reporting is not allowed in other parts of the business world. Why is it here? 4C's powerful analytics allow you to see how they are performing through custom storyboards built specifically for you so you can measure point solution performance. 4C’s independence means freedom from contracts that limit oversight and separation from parties that have vested interests in opposition to yours. Our mission is to serve clients with 4C’s proprietary solutions that cannot be found anywhere else in the marketplace. 4C Symphony is a complete suite of solutions that helps liberate clients from the restraints of the modern healthcare system.

As a fiduciary, you need to ensure you have clarity into your data, are knowledgeable of the costs, and guarantee control and compliance in regard to your healthcare plan. To truly do this as an organization you must have what 4C Symphony offers:

Data Exchange & Supervision

  • Data Warehouse

  • Full Spectrum of Data

  • Compliant Data

  • High Fidelity Exchanges

  • Controlled Consolidation & Augmentation of Data

Spend & Utilization Trending

  • Visualize how your Members are accessing care

  • Monitor Behavioral Patterns of Providers

  • Leverage Reporting for Plan Design and Vendor Accountability

Financial, Clinical and Operational Oversight

  • Advanced Transactional Scoring Engine

  • Oversee and Manage Errors and Issues

  • Stop-Loss Oversight

  • Outlier Analysis Leveraging Machine Learning

  • Invoice Reconciliation

Claims Management Control

  • Comprehensive Recovery Management Tools

  • Collaboration Hub for Clients & Vendors

  • Evaluate the Performance of Current Recoveries Practices

  • Drill Down Capabilities to Understand Remediation Impacts

Now is the time to take the lead in your industry by doing more than just an audit. Go the distance and manage your benefits department like you would in any other part of the business.

Written by:

George A. Murphy

SVP Strategic Relations




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