Eligibility Audit Services

Everybody Play Fair

Ineligible dependents cost you and your employees money. Secova Dependent Eligibility Verification Audit simplifies the identification of ineligible dependents and supports your employees through the whole process. End result…..instant savings for your health plan and an improved ability to offer quality healthcare at affordable rates for everyone! Our solution keeps both companies and health plans accountable, while protecting the interests of both.

Our Dependent Eligibility Verification Audits:

SAVE MONEY

PigOur clients experience on average a
3%–8% reduction of enrolled dependents, equalling multi-million dollar benefit cost reductions – and quickly!

KEEP YOU COMPLIANT

CompliantWe regulate and enforce eligibility
guidelines for enrolling dependents.

The DEVA process Includes:
  • Set up of a project management team in place from planning to completion
  • Progress report calls to keep you aware of any updates about the verification process
  • A project analysis and recommendation presentation to identify specific savings, ROI, and to ensure post- audit compliance with your eligibility rules

Keep the Savings Coming

Without ongoing dependent eligibility verification the number of ineligible dependents could revert to its pre-audit level in three to five years. Through Ongoing Dependent Eligibility Management we make sure your enrollees remain eligible for coverage

Ongoing Dependent Eligibility Management Means:
Requesting, Collecting, Auditing And Maintaining
  • Eligibility verification documentation from newly enrolling dependents
  • Recertification verification documentation on a regular basis
  • Secure online access to Secova’s Dependent Eligibility Management System to view and manage documentation
  • Compliance consulting support for benefit administrators

Coordination of Benefits

DON’T OVERPAY

With the Coordination of Benefits , we make it easy to determine if there are other insurance providers involved in a claim and in what order the providers should be paid. If a member or dependent is covered on more than one insurance plan, coordination of benefits (COB) is an effective way to determining the correct order in which benefits are paid and the amounts which are payable. The audit helps you in understanding which plan pays first, which pays second, and who pays third.

One Two Three