Our Latest Blogs


Navigating the hybrid work scenario

Navigating the hybrid work scenario There’s no doubt that remote work has proven to have many advantages for both employers and employees. And it’s unlikely that we’ll return to a fully in-office arrangement anytime soon. The future of work is hybrid: some employees fully remote, others in the office full-time and the vast majority likely splitting their time between the two. As Stanford professor Nicholas Bloom noted in a recent article, 32% of workers never want to go back to the office, but another 21% never want to work from home again. Companies are evaluating the effectiveness of the hybrid work model, and the jury is still out. Pew Research says that 83% of respondents feel that the hybrid work model will be the future of work. In February 2021, JPMorgan COO Daniel Pinto told CNBC that he saw a zero per cent chance of 100% of people going back to the office, 100% of the time. Theoretically, workers could spend the summer months at a lake house in Minnesota, extend their vacation to Florida by a couple of weeks and work from the beach or even move to a lower-cost city or state. But in practice, this can be a nightmare for payroll and compliance professionals. In fact, some companies have already learned the hard way that there are serious tax and compliance risks involved on both sides of the spectrum. How can you give your employees the flexibility they demand without putting your company at risk? Some companies may have overpromised on the idea of ‘work from anywhere'. Even Spotify’s seemingly wide-open policy comes with some asterisks - specifically, limitations on the jurisdictions in which employees are permitted to work, presumably those where the company has already evaluated and planned for the tax and compliance risk. In addition to establishing a location-based policy where appropriate, there should also be rules for who qualifies for remote work and how. There may be reasons why it’s necessary to have certain roles or individuals in-office, so setting a policy that specifies who can work remotely and under what circumstances can provide a guidepost and avoid ad hoc decisions that can cause issues. Once a policy is in place, it’s imperative to implement a workflow by which employees can request remote work. Often, staff will ask their direct supervisor who may give permission based solely on the impact it may have on productivity, team collaboration and work output. They may not be aware of the payroll and corporate tax implications and, therefore, inadvertently put the company at risk. Companies cannot rely on employees to accurately report their remote work locations. Despite 78% of HR pros saying they were confident their employees would self-report when working in another state or country, the reality is only a third reported all those days to HR. It turns out that the biggest risk is not the employees who are asking for approval — it is those who take the ‘anywhere’ comment literally and jet off to new locations. The only way to accurately track employee location is with technology that’s purpose-built for helping companies maintain compliance. Doing so not only gives finance and HR a much more reliable way to comply with accurate payroll withholding and immigration risk, but also eliminates the burden of reporting for employees. With length-of-stay thresholds for payroll tax withholding that vary from 14 to 30 days or more across jurisdictions, you need to track not only current location but also historical data to validate against those thresholds. Fortunately, 94% of employees are comfortable with being tracked at the country, state and city level. With many employees now working from home at least part of the time, the question of paid time off (PTO) has become more complicated than ever. PTO requests are surging as workers, exhausted and burned out, are scrambling to take the vacations they’ve had to table for more than a year. One survey from management consulting firm Korn Ferry found that 79% of professionals vowed to use more vacation days in 2021, and 46% said they’d take longer vacations than in years past. Even with the clear advantages of remote work, without the right tools and guidelines in place, the risks could quickly far outweigh the benefits. Companies that aim to leverage the flexibility, productivity and diversity of hybrid work must mitigate the compliance nightmare with sound policy, procedures and solutions that allow them to protect themselves, while also keeping employees happy. And here is where Secova can help. Secova provides comprehensive solutions to make sure that your company complies with current regulations and fulfils IRS reporting requirements, besides helping with leave administration by tailoring a program specific to your company’s size, scope and complexity of leave issues. Hybrid work has never been more productive!

14 Sep 2021
Retaining your employees during the Great Resignation

Retaining your employees during the Great Resignation By now, you’ve probably heard of — or experienced — the ‘Great Resignation’, a term coined by Anthony Klotz, an associate professor of management at Texas A&M University, to describe the wave of people rethinking or quitting their jobs post-pandemic. Some 4 million people quit their jobs in April, the highest reported number since 2000. More than 3.6 million people voluntarily left their jobs in May. Prudential posits one in four US workers will look for a new job when the pandemic eases up; Microsoft research finds that 41% of the global workforce is weighing leaving their current employer this year; Monster reports as many as 95% of workers are currently considering changing jobs. There are 9.2 million job openings, but employers can’t fill them. Employees will resign for a number of reasons. A key driver for employees leaving can be feeling undervalued. According to a recent survey, 63% of employees feel that they don’t get enough praise. And 83% of employees think it’s better to give someone praise than a gift. Making sure employees are valued and recognized can be a key driver of retention. But there’s another reason people might quit their jobs: burnout, which disproportionately affects working mothers. One in four women with children under 10 say they considered leaving the workforce during the pandemic, compared with only 13% of men with younger kids, according to research from McKinsey & Company. Women told researchers that they were exhausted from taking on more household and child-rearing duties. A recent Microsoft study confirms employees want the best when it comes to workplace flexibility, with more than 70% of workers desiring flexible remote work options to continue. As organizations get real with remote and hybrid work, they learn that those able to provide workers with the flexibility to work where and when they want to enjoy significant competitive advantage. Research shows 85% of US employees who worked remotely during the pandemic prefer to work either remotely or in hybrid arrangements permanently. According to one study, approximately one in five employees reported leaving their jobs in 2020 due to pay and benefits concerns, with unsatisfactory pay being the top reason. Research shows 72% of companies are updating pay and benefits programs in 2021 to address multiple challenges. They continue to modernize and personalize their health benefits and recognize savings and retirement are a top priority of employees, increasing their focus to further strengthen employees’ financial security. During 2020 and 2021, employees and organizations demonstrated resiliency in light of significant challenges. At the same time, research shows a decline in physical, emotional, financial and social well-being. Employees reported feeling disconnected and the deterioration of workplace social connections has created productivity and stress challenges that can hamper performance. Employers focused on efforts to drive resiliency through efforts that consider workload, time off, counselling, behavioural and mental health assistance, as well as financial well-being support and continuous skilling and development. Unlike 40 years ago, lower-paid employees cannot afford to buy a home or pay for college tuition on their income. College benefits are becoming more popular among all types of employers, including those in the restaurant and retail industry. Some of these programs are even geared to the children of team members instead of workers themselves. Providing access to free or discounted higher education can help improve recruitment and retention efforts. Employers are not only considering solutions such as free college benefits but are also considering matching contributions. While some people welcome going back to an office environment, the reasons for those who dread it are varied and personal. Some are experiencing sadness on missing out on dinner with their families or the freedom to take a walk in the middle of the day. Women and marginalized people may fear experiencing more microaggressions in the office setting. There’s also no denying the increased polarization of political and social views amplified during the pandemic. Creating a work culture built on trust, transparency, and empathy is what makes employees feel safe to show up as their authentic selves. This is the state in which we are all able to contribute our very best, and so directly in the company’s best interest. When employees feel seen and heard, their performance and productivity increases. They feel able to grow, and so will stay, leading to the retention of top talent that is more vital – and more difficult – than ever. At Secova, we’re committed to researching and providing the best services and resources customized for your business. Our data technology, expertise, and education provide tailor-made solutions for every company. We provide a 24/7 benefits administration solution for all employees to make sure they stay. After all, it’s the employees who define the success of a company!

07 Sep 2021
Best ways to track employee time

Best ways to track employee time In addition to the number of other responsibilities on their hands, companies also have to maintain records of employee time off. Sick days, leave, vacation and daily time punches are crucial for businesses to keep track of, as they directly affect budgets and overall efficiency within the organization. This task can be difficult without a set plan in motion. Let's look at the best ways employers can document a worker's time: Spreadsheets are your friend                         Every organization has its own process that works for tracking. Some businesses utilize manual entry. Although time-consuming, companies with a small number of employees often find this practice to be the most beneficial. Employers could utilize a spreadsheet to record time off in an inexpensive way, according to the Houston Chronicle. With these documents, payroll teams can keep track of a worker's starting balance and enter information as time goes on. To make the practice even more efficient, company leaders can enter the appropriate formulas so the spreadsheet does the majority of the work for them. With manual entry, it's crucial for businesses to have a paper trail, so companies should keep record of time off requests and more. Institute an unlimited vacation policyTracking time can be complicated, especially with so many elements to keep record of. To simplify that process, companies could eliminate strict documentation of employee vacations. Many businesses today have implemented unlimited time off practices, as they reduce work for payroll teams and are a strong reward for workers, according to Entrepreneur. These options give people open-ended access to time off and take the pressure of monitoring accrual off the hands – and minds – of company leadership. Although unlimited vacation may not work for all organizations, it can help those with a large pool of employees. Implement helpful softwareBusinesses looking to streamline their payroll process further than manual recording should look into a digital solution that is able to integrate with their current system. These time and attendance applications give employees a username and login so they're able to document upcoming vacation days, sick days and other occasions that require paid time off. These systems aren't relegated just to organizations with a set vacation policy. Those employers who have instituted an unlimited PTO policy can ensure employees are taking advantage of the benefit with the help of this software. HR and payroll teams can request that all workers place their future absences into the software so proper management of responsibilities can be taken. Documenting employees' time off can be a difficult task, especially for companies with a large number of workers. In addition to utilizing spreadsheets for manual entry, testing an unlimited vacation policy and implementing time and attendance software, businesses can also work with a leave administration partner. These third parties can help organizations keep track of employee absences and ensure all necessary government regulations are met. Secova provides a wide array of benefits services from ACA management, online benefits enrollment, eligibility audits and leave administration assistance. Dedicated to providing the highest level of customer service while ensuring companies are compliant with all state and federal standards, Secova is a strong choice for all employee solutions. 

17 Aug 2021
How to prepare for open enrollment

How to prepare for open enrollment The fall season is upon us, and for internal Human Resources departments, this means that preparations for open enrolment must soon begin. As the Society for Human Resource Management noted, some HR professionals dread open enrollment due to the “administrative headaches” it can create. There are numerous considerations to make during this time of year, and it’s important to make sure that employees are aware of their available benefits and understand how to take advantage of them. Thankfully, there are a few key strategies that HR professionals can leverage to prepare themselves and their workforce for the open enrollment season. Provide materials ahead of time and prep for questions Robert Miller, an SHRM member and HR manager for Chapman/Leonard Studio Equipment, recommends circulating benefits materials ahead of open enrollment to make sure employees have a baseline understanding of the available packages. After all, enrollment is a time to delve deeper into options, and it’s important that the HR team use their time efficiently. “[Employees] shouldn’t be asking basic questions about their coverage options in open enrollment meetings; that should happen before open enrollment occurs,” Miller noted. In addition, as materials are disseminated, HR stakeholders can ask workers to review the information and formulate their questions. In this way, the HR team can be more prepared to provide accurate answers. Often, these questions involve things like why coverage is needed, which benefit features will fit employee needs, the value programs provide and how much will be deducted from each pay check. Having this information on hand ahead of time can streamline open enrollment meetings and ensure that employees’ come away feeling informed. Establish an “active” enrollment strategy Employee engagement can be an uphill battle during open enrollment, particularly when workers have the option to simply continue with their previously-selected benefits options. In these cases, staff members may not fully participate in open enrollment meetings and may even be overlooking important benefits available to them. In order to avoid this, Meredith Ryan-Reid of MetLife told SHRM that crafting a more active enrollment strategy that helps side-step passive employee engagement. “Active enrollment makes a huge difference,” Ryan-Reid explained. “Having employees reapply each year requires them to reassess whether they’re making the right choices for themselves and their families. It also helps ensure that you’re getting up-to-date information about your employees and their dependents.” Consider incentives for wellness programs If your business supports wellness programs for health or financial improvement, now is the time to think about providing incentives for participating in these initiatives. Getting these perks ready ahead of time is important, as it enables HR to publicize them during open enrollment. This can be a particularly helpful strategy for organizations that want to boost the impact of their existing programs. Open enrollment can be complex for HR teams, but it doesn’t have to be. A little forethought and planning can go a long way, as can assistance from an expert like Secova. Connect with us today to learn more.

30 Jun 2021
The importance of dependent audits: School district saves considerably on healthcare costs

The importance of dependent audits: School district saves considerably on healthcare costs Many employers provide healthcare coverage for their employees as part of a benefits package, and some take this a step further by extending coverage to the spouses, children and other dependents of its workers. Such a benefit can be considerably advantageous and help attract and retain top talent. However, when a dependent’s status changes and he or she is no longer eligible for this coverage, it’s important that organizations are able to identify and remove these individuals, and keep their health insurance costs in check. One public school district completed an eligibility audit of its workers’ dependents, and was able to identify more than 100 individuals who were actually ineligible for the coverage they were receiving, NBC CT reported. This instance, which could help the district save hundreds of thousands of dollars in the long run, is a reminder of the critical importance of eligibility audits, and helps showcase the benefits of working with an expert, outsourced human resources solution provider. Ineligible dependents: A larger issue than many realize While each company has its own qualifications and definitions outlining eligibility for healthcare coverage – particularly when it comes to dependents – extending coverage to workers’ family members has become a common practice. By the same token, though, as more employers provide this attractive benefit, the issue of ineligible dependents – and the associated high costs – becomes more prevalent as well. In fact, according to New York Times writer Lesley Alderman, dependent audits are not only more common, but more important, as healthcare costs continue to rise by 5 to 10 percent each year. And as EBN reported that it isn’t uncommon for audits to reveal 5 to 15 percent of a dependent population being ineligible for coverage, employers’ healthcare costs can considerably add up. The issue here is larger than many realize, as dependents can become ineligible for many routine reasons. A child of a worker turning 26 or the divorce of a spouse can cause a dependent to become ineligible for coverage. John Fazio, a senior consultant and benefits administration industry expert, told Alderman that an audit of a 10,000-employee company will usually identify 200 to 500 ineligible individuals. “Dependent audits have been around for more than a decade,” Alderman wrote. “But they have become popular in the last few years, as employers desperately sought ways to trim their health care budgets. From an employer’s perspective, audits make good business sense.” If your organization has yet to complete an eligibility audit, now may be the time. Such a process is critically important, and is best undertaken with the help of an expert like Secova. To find out more, connect with us today.

14 Jun 2021
Secova and TASC Partner for Benefits

Secova and TASC Partner for Benefits June 2, 2021 – In this time of change, Secova and TASC (Total Administrative Services Corporation) have joined forces to make benefits feel like benefits. Through this partnership, employers will now be able to sign up for all their benefits on one platform. Secova’s online, comprehensive benefits enrollment platform makes it easier to process elections, complete life events changes, educate employees, reduce paper transactions, and enable expansive flexible benefit accounts by bringing them all together. Too often, the experience of signing up for and utilizing multiple benefits is so difficult, frustrating and time-consuming that employees simply don’t use them. With TASC’s Universal Benefit Account®, Secova adds secure and comprehensive benefit offerings to the BenAssure platform, thus making it easier and offering a world-class customer experience for employers and their employees. “A unified platform is the key to increasing flexibility in all aspects of benefits administration,” says Ron Lupi, Secova executive. “We are impressed with the more than 50 different benefits offerings that TASC’s Universal Benefit Account can provide our clients. In today’s ever-changing work and benefit environment, employers need the ability to adapt benefit offerings to work for their business and employees.” The importance of increasing engagement through benefit enhancement can’t be ignored. A study by the Workplace Research Foundation found that employees who are highly engaged are 38% more likely to offer their employers above-average productivity. A successful benefits program requires more than a strategic selection of the benefits themselves. “A benefit is only as good as the experience an employee has in accessing it — and that’s where many company benefit programs fall short. This includes not having a platform that brings all benefits together. That’s what we see in partnering with Secova, a single platform where all employer offerings are together — how you present benefits does matter,” shares Dawn Mortimer, Chief Innovation Officer. “The expectation today, for most employees, and particularly millennials who are tech savvy, is a seamless digital user experience; the expectation is one platform with one portal, one password, one card, and a user experience that’s the same across all devices.” About Secova Founded in 1989, Secova is a results-oriented third-party administrator with a track record of delivering cost savings and customer-satisfying solutions. Secova provides customized solutions for the administration of employee benefits and human resources, resulting in more efficient HR operations, increased data visibility, and comprehensive auditing capabilities. The Secova solution offers 24×7 Health & Welfare services without requiring our clients to choose between quality and breadth. Secova processes more than 80 million eligibility records, $1 billion in healthcare premiums, and manages over 450 vendor/carrier relationships annually on behalf of its clients. For more information, visit http://www.secova.com or email at info@secova.com. About TASC TASC started in 1975 with a simple, yet innovative idea of enabling small businesses to reap the same tax advantages as larger companies. As the nation’s largest privately-held third-party benefits administrator (TPA) with new innovations every two years since 2001, TASC now serves over 80,000 small, medium and large customers. In addition to being the only TPA that offers hold harmless agreements or audit guarantees for your protection, TASC is blazing new trails with a one-of-a-kind, industry first, instantly configurable benefits cloud platform. For more information, visit www.tasclargemarkets.com/sso or call toll free 1-800-422-4661.

03 Jun 2021
How to make dependent eligibility audits run smoothly

How to make dependent eligibility audits run smoothly There's no doubt dependent eligibility verification is important. Employers can save their companies thousands of dollars by conducting regular dependent eligibility audits. This is a process where employees submit documentation to verify that the people covered on their health insurance plan still qualify for coverage. Ineligible dependents who do not meet the requirements for health care coverage are removed from the employer's plan. This process saves employers a lot of money on employee premiums. Audits can also help companies avoid the risk of violating IRS regulations by providing health coverage to ineligible dependents, the Society for Human Resource Management reported. In fact, third-party providers of eligibility audits report that as many as 10 percent of people receiving coverage have been ineligible in the past few years, SHRM reported. But this process can be confusing and intimidating to some employers who might not know what to do when verifying benefits coverage or how to communicate its purpose to workers. Here are some pointers to ensure employers don't encounter any problems as they go through this important process: When should my company conduct an audit?How often a business owner should consider a dependent audit depends on a variety of factors, including the rate of company turnover, the size of the business and the type of health care plan it offers employees.  For those with a low turnover, it shouldn't be necessary to conduct an eligibility audit more than once every three years, according to Employee Benefits Adviser. But companies that have people coming and going at an above average rate should consider implementing audits on an annual or every other year basis. This will ensure new employees and their dependents are in compliance with coverage guidelines and help reduce costly coverage for those who don't qualify for it. During this stage, it's also crucial to convey why this process is important for the company. In certain cases, employees can be resentful of the verification process because they see it as employers not wanting to offer health insurance to their significant others. It's critical for business owners to communicate that these audits are in the best interest of the company and further business and employee well-being for the long term. For instance, employers should say that if ineligible individuals are no longer covered, health care premiums will go down, which means less out-of-pocket expenses for both employers and employees. Before an audit begins, employers should look over any company health plan documents – such as the summary plan description – in addition to any other relevant enrollment materials, according to Smart Business. What do my employees need for an audit?To start the process off on the right foot, employers need to clearly communicate what is expected of workers while an audit is being completed. During this process, employees will be asked to turn over documentation that verifies the employee's relationship to their dependents. Employees might be asked to procure documents such as marriage certificates, mortgage or lease agreements or birth certificates among other paperwork depending on who is considered a dependent on the worker's plan. The clearer an employer is about what documentation is needed to conduct the audit, the more streamlined the process can be for everybody involved. The amount of time it takes to complete dependent eligibility verification will vary company to company, but employers should prepare for the process to last  up to several months. Business owners also need to decide if they are handling the audit internally or if they will need to contract with an outside vendor to get the job done. What happens after the audit?Once the results of an audit have come in, employers can determine who is still eligible for coverage and who will be taken off the company's health insurance plan. Dependents can be found ineligible for a number of reasons, and often it's simply because an employee didn't fully understand the requirements for coverage. It's important to communicate the overall benefits of conducting an audit and to educate employees so they understand which dependents are eligible going forward. Although there are clear cost-saving benefits to audits, business owners need to take special care to ensure that audits are done as efficiently and accurately as possible. Secova offers companies of all sizes a team of experienced professionals who can lead business owners through the audit process should they decide their business needs one.

27 May 2021
Graduates are on the search for employment: Here’s how you can attract them to your business

Graduates are on the search for employment: Here’s how you can attract them to your business   Summertime is upon us, and that also means that school is out and there is a brand new crop of recent graduates holding advanced degrees, hungry for their first professional job opportunity. According to data from the National Center for Education Statistics, more than 20 million students attended American institutions of higher education this past fall, meaning there is a considerable population of young professionals getting ready to enter the job market. However, recruiters looking to attract these recent graduates must do more than create a few job postings across different websites – competition for this young workforce is fierce. Let’s take a look at a few ways Human Resource teams and their recruitment experts can provide a compelling and attractive working environment for new college graduates. 1. Establish, live and sell your company culture Every company has its own unique culture and brand image. And while not every organization will be the next Google – with a casual dress code, gourmet meals and napping areas – your organization should look to create its own culture, and leverage it as a way to attract new employees. Gallup researchers found that one-third of young professionals view company culture as an important aspect in employment, but businesses must do more to help workers connect with their organization’s mission and culture. Creating a mission statement that employees can believe in, and reinforcing these values through top-down leadership buy-in and clear communication can help stakeholders create a culture that the company can be proud of – and one which will help workers strongly connect with the business and do their part to fulfill its mission. 2. Understand and appreciate their needs As Entrepreneur guest writer Dan Lauer noted, millennials and the younger workforce have different needs and style of ambition than their predecessors. Currently, many individuals entering the job market have high degrees, but seek out opportunities that will provide them with a beneficial work-life balance. Recent graduates are looking to climb the career ladder, but not at the expense of fulfilling their other personal goals and pursuits. In this type of landscape, enabling flexibility is key. In fact, a recent study from Qualtrics found that 37% of young professionals would accept a lower pay rate in exchange for more flexibility in their working schedule, CNBC reported. 3. Provide unique benefits and support them with innovative technology Flexible working hours are just one example of the kinds of distinctive job perks that recent graduates are seeking out. Another option that’s especially helpful for targeting recent graduates is student loan assistance. Decision-makers can consider partnering with an organization like GotZoom to provide this benefit. Because many young professionals are entering the workforce with more debt, offering this kind of support could be just what’s needed to help your business stand out with job-seeking young professionals. No matter what benefits you elect to provide, it’s important to support these with technology that speaks to the young generation. Mobile access and online enrollment, for example, is especially advantageous and enables employees to interact with benefits administration services in a familiar and easy-to-use portal. Some of these capabilities and strategies will take time to implement, while others will be more immediate. However, all will require robust support from the executive suite, down throughout the company. To find out more, connect with the experts at Secova today.

10 May 2021
Top 3 reasons to outsource eligibility audit services

Top 3 reasons to outsource eligibility audit services It’s difficult for businesses to keep track of all eligible dependents currently on their healthcare. Regular record inspection is necessary to make sure the company isn’t providing benefits for people who are no longer qualified to receive coverage under new regulations. Organizations can choose to outsource the responsibility and have third-party experts conduct these audits for them. Let’s take a look at why businesses choose this approach: 1. Cost efficiency Healthcare coverage for ineligible dependents is a costly problem that requires immediate action from employers. According to a study from Colonial Life & Accident Insurance Company and the Government Finance Officers Association, 8% of people enrolled in a business’s medical plan are not qualified to receive the coverage based on the plan’s criteria. These ineligible dependents could drive the cost of healthcare up for both employers and their workers, according to Modern Healthcare. Outsourcing the obligation to perform eligibility audits and other services will allow a team of experienced professionals to take a closer look at company records. These third parties can pinpoint ineligible participants quickly and provide a more systematic dependent verification process. 2. Reduction of time Similar to the added monetary costs of covering ineligible dependents, performing research into company and employee records can cost businesses valuable time. Utilizing an outside organization to complete eligibility audit services allows employers to focus on more important and relevant responsibilities. Third-party providers can also offer unqualified participants the resources to help them find alternative means of healthcare coverage, taking even more of the stress off employers. 3. Understanding of appeals process People may want to appeal the findings of the analysis, so companies must be prepared for these events. Unfortunately, not all employers have the necessary knowledge to complete this process in a streamlined and detailed manner. Also, the appeals procedure is just another time-consuming step for businesses that already have too many obligations to contend with. Organizations that provide eligibility audit services are able to assist with these disagreements. Third-party companies will likely already have a system for reviewing audit results and deciding whether or not certain cases should be reinstated. According to the Colonial Life and GFOA study, re-entry of once-ineligible dependents usually occurs when missing documents are found or submitted by workers. Employers have a variety of responsibilities to take care of on a regular basis. Since providing healthcare coverage to employees has become one of the largest obligations for businesses – failure to do so could result in expensive penalties – it’s important for companies to be as prepared as possible. These benefits can cost employers a lot of money, especially if costs are increased due to dependents who are technically not eligible. It’s crucial that organizations offering health insurance perform regular eligibility audits to ensure no unqualified participants are flying under the company’s radar. Outsourcing these services to a third party can save businesses time and money while also providing enterprises with an experienced team of experts who truly understand each step of the process.  To learn more regarding Eligibility Audit Services, connect with Secova today. 

29 Apr 2021
The role of Artificial Intelligence in healthcare

While it’s true that the healthcare industry is witnessing a record-breaking year in digital health investments, the AHA simultaneously projects healthcare’s financial losses at more than $300 billion in 2020. Due to the pandemic, healthcare institutions are increasingly turning to digital and artificial intelligence (AI) solutions that streamline behind-the-scenes functions and alleviate administrative and operational spending. Many hospitals are seeing immediate results from such investments in departments and functions that involve error-prone, repetitive, time-intensive tasks. And one function fraught with such tasks is claims processing and reimbursement. It involves a myriad of stakeholders and steps, such as validation, justification, authenticity, and payment. Each step of the process is just as crucial as the last, making efficient and accurate communication critical for success. It is no surprise that the reimbursement and claims processing work stream primarily consists of high-volume and repetitive tasks, such as collecting and inputting patient and provider data. When a mistake in the process is made, such as incorrect billing or erroneous patient documentation, the process is further delayed. Payers, providers, and patients alike are faced with extra back-and-forth communication to reconfirm details for the medical claim. This issue transcends the billing cycle and can directly impact payers, as well. Continually delayed claims can make hospitals leery of accepting certain plans or even entire carriers. A lower number of accepted plans results in benefit brokers only being able to offer a small range of options to their clients. Ultimately, this leads to employers providing health plans for their employees only having a limited number of options to choose from. As more and more hospitals understand the magnitude of these issues, they are implementing AI solutions to help streamline the claims processing and reimbursement process. AI automates these critical but repetitive tasks to reduce mistakes, enhance workflows, and let hospital staff focus on tasks that require a human touch. AI is also being used to minimize the hefty costs associated with insurance claim denials. With AI, providers are able to identify and mitigate erroneous claims before the insurance company denies payment for them. Not only does this streamline the process, but it also saves hospital staff the time it would take to work through the denial and resubmit the claim. With faster payments and greater accuracy, hospitals are more willing to accept a wider number of plans, which means benefits brokers can offer a broader range of options to their clients. Hospitals are continuing to reimagine the claims process, with AI in mind. In fact, recent research indicates that 61% of hospital leaders are looking to implement AI/RPA within the next two years. Hospitals will continue leveraging AI solutions to streamline backend functions to reduce operational costs, alleviate administrative spending, and allow employees to focus on more important tasks. Just what the doctor ordered Also, when searching for the best surgeon, consumers may get a major assist from AI, a new study says. The report in the Journal of Medical Internet Research (JMIR) compared healthcare decision-making based on a range of choices: consumer ratings; quality stars; reputation rankings; volumes and outcomes; and precision machine learning-based rankings. That last category looked at a type of AI that uses data to determine whether a hospital is a good fit for a potential patient. The study found that the machine-learning approach to picking a surgeon delivered better outcomes than choosing surgeons by other methods. The AI approach allows a more personalized choice—the algorithm matches the patient to the hospital that has the best outcomes for patients with similar profiles. Benefits in administration AI offers employers and brokers an opportunity to maximize the impact and efficiency of their offerings and human resource programs. In 2021, and in the wake of COVID-19, the role of AI will grow as companies continue to transition to long-term remote work, tackle COVID-19-related expenses, educate employees on their health benefits, and introduce benefits platforms to address individual needs better. In 2021, we’ll likely see AI play a more significant role in helping employees avoid burnout through tools that encourage real-time engagement, provide individualized recommendations on how people can do their best work, and robot coaches. For HR teams, AI-powered solutions will quickly flag employee roadblocks and prioritize those most at risk. Greater use of remote teams also means more integration of HR and day-to-day collaboration tools. HR data analytics’ power is in how it can proactively assist in more accurately predicting annual benefits costs—a tool that will become crucially important for families, employers, and health plan providers as they plan for this year. This emerging, critical decision-making data will play a key role for brokers, employers, and health plan providers as they navigate both expected and unexpected changes. With COVID-19-related fraud also on the rise, health plan providers and employers who use HR data analytic tools to spot and flag outliers could save themselves hundreds of thousands of dollars. In 2021, health plan providers and employers expect employees to prioritize flexibility and personalization in their healthcare coverage to meet their unique needs and challenges. With budgets top of mind in 2021, employers and employees will continue to use these financial tools to save money and lower medical plan premiums. Brokers, health plan providers, and employers will continue to leverage AI to educate employees on their medical costs and personalize their benefits based on their current and projected future needs. Insight-driven benefits administration relies on automated platforms to collect, aggregate, streamline, and analyze data from multiple systems to produce actionable steps to drive value. These platforms will only become more essential as companies continue to adapt to the changes seen in 2020. As priorities continue to shift in 2021, the demand for employee data to evaluate workplace wellness programs, retention, and benefits will grow. But seamless interaction with personalized benefits program offerings will likely provide the most significant avenue for growth of modern benefits platforms. Modern benefits platforms will become an even more essential tool to health plan providers and brokers in the coming year as they allow them to reach the end consumer more effectively. AI will continue to drive evolution in the benefits space. While many things changed in 2020, data is still the most dependable way to understand what is happening now and predict the future. As everyone adjusts to the changes on the horizon, we will continue to rely on the data and insights AI provides to support the healthy growth of the benefits ecosystem. At a glance: * Healthcare industry’s financial losses projected at more than $300 billion in 2020 * 61% of hospital leaders are looking to implement AI/RPA within the next two years * AI automates repetitive tasks to reduce mistakes, enhance workflows * AI is being used to minimize the hefty costs associated with insurance claim denials * AI uses data to determine whether a hospital is a good fit for a potential patient * HR data analytic tools can be used to save hundreds of thousands of dollars * Benefits administration relies on automated platforms to collect and analyze data

20 Apr 2021
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