Risky Benefits

Consolidated Billing - Risky Benefits Podcast S5E7

• David Holloway-Boyd • Season 5 • Episode 7

Share episode

Welcome to another episode of Risky Benefits! In this episode, we welcome back Emily Faimoa, Vice President of Client Administration at FBMC, to discuss the intricacies of consolidated billing and reconciliation. Emily elaborates on how her team alleviates the burdens faced by HR, payroll, and accounting teams by managing multiple vendor payments, providing concise invoicing, and performing detailed reconciliations. Emily explains how their services streamline benefits administration, ensuring employees' benefits are managed accurately and efficiently. Tune in to learn how consolidated billing and reconciliation can simplify your organization's benefits process.

To listen in and subscribe to more episodes, visit our website: fbmc.com/podcast.

Hey, thank you for listening in to Risky Benefits, a podcast that informs you on all things benefits. We've got a saying around here, benefits isn't your main business. It's ours.

farris_1_02-27-2025_131438:

Hey everyone. Thank you for listening to Risky Benefits and welcome to this week's episode. Our returning guest this week is Emily faa. Emily is our Vice President of Client Administration. Hi. And we had Emily on last year to discuss our specialty billing services and we enjoyed talking with her so much that we wanted to have her back to learn more about the other things that our team does, specifically consolidated billing and reconciliation. And let's just like address the elephant in the room. Nobody listening to this, with the exception of just a mere few know what that. Even means, nor probably should they, I would venture to say, did know what it meant. Like something bad happened and probably your insurance policies weren't getting paid for, and it was a catastrophe. So. We're gonna talk about it'cause it's highly important. But the joke of it is, is hopefully you never have to hear about it.'cause people like Emily do such a good job that like there's no reason for you to know what's going on.'cause it all happens behind the scenes of the insurance products that you have to protect you and your families. But it's good for you to understand it in case something does go wrong and or so you can have a full appreciation of the people that provide your services. So without further ado, Emily, you for coming on again.

squadcaster-03ba_1_02-27-2025_121438:

Thank you for having me back.

farris_1_02-27-2025_131438:

Yeah, it's great to have you. Let's start by giving the listeners a recap, just a little bit about who you are what you do for the team, just as a reminder.

squadcaster-03ba_1_02-27-2025_121438:

Yeah, so, Emily Ola vice President of Client Administration. So I oversee our team that handles our TPA services and our call center. And like you mentioned, the last time I was on here, we talked about our specialty billing. So direct billing. Um, members. Members. And today I'm excited'cause we're going to talk about another service that we offer. And this is for our clients who deduct premiums through payroll. So I'm excited to talk about this. I'm probably the only one who's excited.

farris_1_02-27-2025_131438:

I was like, are you, Emily, are you excited? She's so excited. Alright. I'm excited too. Cool. Okay, so let's start with the obvious. Billing and reconciliation are a nightmare. When you're dealing with multiple vendors and service providers you can get buried with invoices, payment firms, tracking payments, et cetera. It can be tedious and inefficient. How does your team work with our clients to help reduce this headache?

squadcaster-03ba_1_02-27-2025_121438:

Yeah, so Kila, you nailed it. I mean, that's exactly why we provide this service. We wanna take the burden off of those payroll HR and even accounting teams when we're talking about multiple payments go into the different carriers. So this can be very time consuming. So think about an employee's or employer's benefit package with all the products, all the different carriers. They all have their own unique billing cycles. They have their own way of actually getting invoices to the client. So some email them, some you have to log onto their portal and grab them. So it creates a level of chaos when you're trying to just gather all the details.

farris_1_02-27-2025_131438:

So when you say Emily, when you say them, are you talking about the carriers?

squadcaster-03ba_1_02-27-2025_121438:

yes,

farris_1_02-27-2025_131438:

Okay. Okay.

squadcaster-03ba_1_02-27-2025_121438:

And then for the client they're trying to gather all the staff, get it paid, so they're paying multiple vendors. Also the carriers require different forms of backup with those payments. So that's falling on the client to figure out, okay, how do we. Get this backup to them in the way that they need so it can become a full-time job and very, very time consuming. So if you partner with us, what we do we take all of the enrollment elections regardless of carrier. We consolidate those into one nice invoice provide that to the client, and they get to pay one time. So they're paying funds to us one time instead to the multiple carriers. We take those funds and we remit them on their behalf. So we're also taking care of the backend stuff too, that, that remittance detail, that backup documentation as well.

farris_1_02-27-2025_131438:

That's awesome. So I'm assuming, if I were to ask, the advantages of using your team for these services, it's gonna tie into basically reduced work on the HR department. How might you address that? Like what, why would somebody want to utilize your services beyond the obvious of just managing the process you just spoke of?

squadcaster-03ba_1_02-27-2025_121438:

Yeah I mean, we have the best team too. So that's the obvious, right? We're phenomenal. No but seriously, we do, we have the best team. They know their role in this. So this goes all the way down to a member having access to their benefits. We understand that premium re minutes is a huge part of that. So we take our job very seriously. We wanna make sure those funds are passed to the carriers so that they have access to, to their benefits when they need them. So that's one that's the obvious, right? The second is obviously the invoicing that we just talked about, but we actually take it one step further. So we also provide a reconciliation service. So after each payroll we ask for a deduction register. We receive that deduction register, and we reconcile back to the enrollment system as well as the carriers. So if we have a list bill situation so we are doing this on a monthly basis. We're identifying those discrepancies in payroll, letting our client know what those are so they can take care of'em on their next payroll cycle. If they were not using us, then they would not they would be having to identify those discrepancies themselves. So again, we're taking work off of them.

farris_1_02-27-2025_131438:

And so Emily, you you're licensed and registered as a TPA in a multitude of states. That then means that you're essentially a fiduciary on for the services that you provide, and that in and of itself means that there's some kind of weight to the service you're providing.

squadcaster-03ba_1_02-27-2025_121438:

No, that's correct. And we are licensed in all 50 states so that we can provide these services anywhere. Another thing I wanna mention that I think is critical we do this on a monthly basis. So we mentioned the team being able to take care of their payroll or take care, care of any discrepancies on their next payroll cycle. But I think more importantly we're looking at the big picture. So a lot of times we see businesses that they don't find there's an issue until the end of the year. So their accounting team, they're cleaning up their books they're getting ready for audit, closing out year ends, and they realize we've been paying the carriers, but we haven't been collecting or deducting from those members the correct amount. So we have a gap there. They're left with a bag, literally trying to figure out how to make up that difference. And so by us performing these services on a monthly basis, we reduce that and try to help them keep their books in alignment. No one ever wants to go back to a member at the end of the year as an employer and tell them we didn't deduct from your paycheck correctly, and now we've gotta collect. I mean, that's no conversation that anyone wants to have. So it's really important,

farris_1_02-27-2025_131438:

Yeah, because I guess you'd get yourself into a scenario where the employee may be like, well, I can't afford to have that taken outta my paycheck. I gotta have, I gotta drop this policy or something like that. Yeah. Then if something catastrophic happens and they didn't have the coverage, now they're them and their family are really in a bad way. It stands to reason that. One would want to keep it's probably should be best case business practice.

squadcaster-03ba_1_02-27-2025_121438:

Absolutely.

farris_1_02-27-2025_131438:

Yeah. Or the business standard I guess. Yeah. Emily, you mentioned something you said that you reconcile with the enrollment systems. Do you guys have any limitations on what systems.

squadcaster-03ba_1_02-27-2025_121438:

We do not have limitations with systems. So we've built our process where we can actually support any system. And so we worked during implementation to, to figure out how we're going to gather that data. But we do not have a limitation with systems, so thank you for asking that.

farris_1_02-27-2025_131438:

Yeah, so is there any specific group type or size that could benefit most from this type of service?

squadcaster-03ba_1_02-27-2025_121438:

So, we have built our process where we can support not only the mid, large and jumbo cases but also downstream. So when you think about an employer, let's say 200 and below lives those employers are, when you really look at a staffing structure. you may have one person who's wearing many hats, you may have one person who is payroll, they're accounting, they're also hr, and they really can utilize some help in these areas. So I mean, really we can support both up and downstream. It's just depends on the client's needs.

farris_1_02-27-2025_131438:

That's cool. How about success stories? Any that you'd like to share? I.

squadcaster-03ba_1_02-27-2025_121438:

yeah. One that comes to mind I would say is a group. They were about. Probably seven 50 lives. They joined us. We took over their billing and reconciliation and within the first month we were actually able to identify a substantial amount of discrepancies. And they were anywhere from paying for members who had already terminated to people who change plans. And with our help, we were able to help them recoup around$50,000 that they had been paying.

farris_1_02-27-2025_131438:

that's a significant chunk of change.

squadcaster-03ba_1_02-27-2025_121438:

Yes.

farris_1_02-27-2025_131438:

is there anything else that makes our solution different from others?

squadcaster-03ba_1_02-27-2025_121438:

I would say the biggest piece is the reconciliation that we just talked about, the payroll reconciliation. I. So, consolidated invoicing or billing, however you refer to it, it's in the market, it's available pretty much any TPA out there is going to offer that service. Where we differ is in the reconciliation piece. So others may say they perform a reconciliation and typically what they're doing is like a percent margin or they have a certain threshold that is agreeable and so they reconcile that way. But we truly reconcile down to the member level. So every dollar that comes into our department, every penny we're accounting for that and making sure it's routed to the appropriate location. So we're good stewards of those funds.

farris_1_02-27-2025_131438:

That's awesome. Well, Emily I really don't think that there's too much more that we planned on getting into. I think this gives like a good summation or kind of coverage of what it's, that you guys are doing. But I do wanna say just kind of a final question for you, which is there anything else that.

squadcaster-03ba_1_02-27-2025_121438:

I think I would like to share just you know, stats or maybe give the listeners an idea of volume of what we handle each month. I think it shows how streamlined and efficient our process is. So just for the service alone, each month we're reconciling for around 115,000 plus lives and around$23 million in premium.

farris_1_02-27-2025_131438:

That's awesome. Well, we're certainly grateful that you do it. I know our clients are. For those of you who are out there listening we'd love to hear from you if this is something you're interested in. Emily, thank you very much for coming on today.

squadcaster-03ba_1_02-27-2025_121438:

Thank you for having me.

farris_1_02-27-2025_131438:

Absolutely, and thank you to the listeners out there. Just know if you have any questions. Please contact us or look for information on our website@www.fbmc.com. And remember, you can find us and subscribe on any podcast app. Thanks and have a great day.