A sample shows patterns. A review of every claim finds the one large error.
The cheapest dollar to recover is the one that is never paid wrongly.
Why samples fall short.
Errors do not spread evenly.
Sampling Misses Outliers
One large misprocessed claim can cost more than many small ones, and a sample can skip it.
After-the-Fact Correction
Finding errors after payment means recovery work instead of prevention.
Silent Errors
Errors that nobody looks for stay in the plan year after year.
What full review looks like.
Routine monitoring, not a one-time sweep.
Every Claim
Routine monitoring can examine all claims rather than a statistical sample.
Ongoing
Review runs through the year so problems surface early.
Reported Back
Findings come back to you in plain terms with what to do next.
When it is practical.
It depends on the data.
Funding Matters
How the plan is funded determines what claims data is available.
Data Access
We tell you what the plan can give us.
Scale
The review works for different group sizes, with scope set to fit.
Questions Employers Ask About This
Does every group get this?
It depends on funding and data access. We tell you what is practical.
Does it replace the carrier’s own review?
No. It adds an independent check on top of it.
What happens when an error is found?
We report it, and if money was paid wrongly we pursue the recovery.
Related guides.
From Renewals to Results: The Broker Playbook
The full playbook.
Dependent Eligibility Verification for Group Health Plans
Verification done fairly.
Group Health Claims Overpayment Recovery
Recovery, followed through.
Want this applied to your renewal?
Send us the renewal and we will run it through DATUM and show you where the number comes from.
Your renewal letter
Your census
Your current plan documents
Your renewal date
Rough answers are fine. We build the numbers from there.
Laws and rules referenced
Employee Benefit News: Renewals to Results — Opinion piece on brokers moving from plan shopping to data-driven advisory work.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
Switch to CFH. Unhappy with your broker? Your employees won’t notice. You will. →
Cookies on This Site
We use cookies to keep the site working properly and to understand how it is used. You can decline anything that is not essential. See our Privacy Policy for the detail.
- Essential — needed for the site to load and for you to move around it. These cannot be switched off.
- Analytics — tell us which pages get read, so we know what is worth writing more of.
- Advertising — set by third parties such as ad and social platforms to measure and target campaigns.