We're excited to announce our partnership with WE (Wasson Enterprise) and Ascendant Advisory Group - a collaboration that will accelerate our mission to revolutionize healthcare claims auditing and recovery services. "This partnership empowers Healthcare Horizons to accelerate our growth while delivering even greater value for our clients. We're not just expanding our capabilities—this marks a pivotal chapter in our journey to break the traditional model of managing healthcare dollars." - Randy King, President With continued leadership under President Randy King and Dev Warren joining as CEO, we remain committed to helping organizations identify claim payment errors, recover overpayments, and deliver measurable ROI through our proven data analytics and proprietary methodologies. Read the full press release: https://lnkd.in/ewP6Wb7u
Healthcare Horizons
Hospitals and Health Care
Knoxville, TN 835 followers
Smarter Audits. Stronger Partnerships. Better Outcomes.
About us
Healthcare Horizons, LLC is a leading expert in providing healthcare claims audit services and assessing the performance of claims payers through our 100% Difference model. Since 1999, our comprehensive claims audits and out-of-network fee negotiation services have been protecting the financial interests of some of the world’s largest self-insured employers. One of the unintended consequences of self-insuring is that claims payers have no financial incentive to control costs. We help our clients manage healthcare expenses and keep costs in check. At Healthcare Horizons, we make it right. • The 100% Difference means we turn over every stone. Random sample audits will not look at every claim, possibly leaving thousands of dollars paid in error. Our comprehensive audits review 100% of claims paid, analyzing all claims data to find errors. The recovered dollars are returned to YOU. • Our executive team is involved in every audit, and our expert data review process triggers the creation of custom queries for "best probable error" selection, identifying more systemic errors and ensuring long-term savings for our clients. • We test areas such as benefit maximums and exclusions that could impact members if recovery is initiated, and we alert employers so they can make recovery decisions. You are in charge, and you determine which claims to recover. We work with your TPA to monitor collections and help negotiate credits or settlements. Healthcare Horizons has built excellent working relationships with external audit coordinators at every national TPA across the country. Our team has identified millions of recoverable dollars for our clients since 1993.
- Website
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http://healthcarehorizons.com
External link for Healthcare Horizons
- Industry
- Hospitals and Health Care
- Company size
- 11-50 employees
- Headquarters
- Knoxville, TN
- Type
- Privately Held
- Founded
- 1999
- Specialties
- Medical claim audits for self-insured employers, Dental claim audits for self-insured employers, and Pharmacy claims audits for self-insured employers
Locations
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Primary
Get directions
800 S Gay St
Suite 1600
Knoxville, TN 37929, US
Employees at Healthcare Horizons
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Ed Pershing
Founder of Healthcare Horizons, co-founder and retired CEO of PYA, Chairman Of The Board at Provectus Biopharmaceuticals Inc.
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Dev Warren
CEO Ascendant Advisory Group and Healthcare Horizons
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Michael Lingle
Chief Strategy Officer @Wasson Enterprise
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Randy King
President - Healthcare Horizons
Updates
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😍Stellar reviews are our love language! #medicalclaimsaudit #SelfFunded #SelfFundedInsurance
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📈" As healthcare cost continue to rise, employers remain committed to their benefits programs, with only 4% decreasing their health care spend this year and 43% increasing it, the 2025 NFP U.S. Benefits Trend Report found. Among other key trends." Check out this article that dives deeper into how employers are dealing with these rising costs. #EmployeeBenefits #MedicalCosts #SelfFundedAudits https://lnkd.in/eUEvHD69
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✅Full Audit, Full Recovery Random sampling can't catch everything. Healthcare Horizons' exhaustive audits provide comprehensive error detection and significant overpayment recoveries, protecting your bottom line. visit our website to learn more: https://lnkd.in/dCcCn8k #MedicalClaimsAudit #MedicalClaims #SelfFundedInsurance
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🎲Why gamble with random sampling? Healthcare Horizons' comprehensive audits scrutinize every claim, uncovering both isolated and systemic errors for optimal financial recovery. #SelfFundedInsurance #MedicalClaimsAudit #EveryClaimEveryTime
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⭐Our Promise to Our Clients When you engage with Healthcare Horizons, you can feel secure in knowing we believe in uncompromising ethics and accuracy and are protecting your company’s financial interest, ensuring your health insurance payments are being paid as accurately as possible. Our 100% Difference approach assures you that you have successfully identified, rectified, and facilitated the recovery of approved dollars of overpaid claims via a process that yields more comprehensive results and leads to future savings. We do all of this with sensitivity to your TPA relationship and make the process simple so you can focus on your core business and productivity. You have access to our leadership, assuring you that your business is important to us. #SelfFundedInsurance #EmployeeBenefits #IntegrityMattters
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One of the unintended consequences of #SelfFunded insuring is that claims payers have no financial incentive to control costs and can unintentionally make errors that may range, on average, from 1-3% - costing self-insured employers potentially hundreds of thousands of dollars each year! 🔎A simple fix - have your medical claims audited for errors. #MedicalClaimsAudits #EmployeeBenefits #HealthcareHorizons
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⚠️Waiting to find errors in your healthcare claims data is costing your company money. That money could be passed on to plan participants through reduced deductibles. Or the savings found in duplicate payouts, for example, can be returned to your bottom line and help fund other initiatives. Contact Healthcare Horizons for an initial review of your administrative plan to determine your best next steps to minimize the impact of rising costs. #SelfFunded #SelfFundedInsurance #EmployeeHealthcare
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🎇Let's make 2025 a year of health, prosperity, and smart insurance strategies! As we step into the New Year, it's the perfect time to ensure you're getting the most out of your self-funded insurance plan. Embrace the opportunities of 2025 by optimizing your plan for maximum benefits and financial health. Healthcare Horizons can help you start the year off right with a focus on smart healthcare choices and strategic planning. #SelfFunded #SelfFundedInsurance #HealthcareGoals #EmployeeBenefits
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Healthcare Horizons' comprehensive audits review every healthcare claim - with expert eyes - rather than random selection. This approach yields improved results because we identify both isolated and systemic errors and assign actual dollar impact to those errors, making a much stronger case to the payer. As a result, employers can recover significantly more in overpayments and can correct systemic issues, preventing future claims paid in error. Drawbacks to random sample audits include: 🚨Impossible to determine if errors are isolated or systemic. 🚨Likely that significant errors exist outside of the sample selection. 🚨Difficult to convince payers to issue settlements based on results. #EveryClaim #SelfFundedInsurance #SelfPayInsurance #EmployeeBenefits