Kari Niblack's guest appearances

Kari Niblack

West Virginia University Mountaineers

The ShiftShapers Podcast

Leading From the Front!

Jason Treu

Scott Smith

Matthew Pollard

Alan Cohen

James Madison

Chris Prefontaine

Tom Scott

Mike Carey

Michael Walsh

Michael Zipursky

Brian Clarke

Kevin Lee

Josh Butler

Chris Johnson

Lisa Morton

OwlTail

This week’s episode features a conversation with Kari Niblack, CEO at ACS Benefit Services. TPAs now offer novel and customizable plans while still providing traditional services like manual adjudication and appeals. At the same time, TPAs now assist smaller companies who are on level-funded plans to take the leap into partially-self-funded plans. In 2021 and beyond, data and transparency must be used to help clients make more informed decisions on the plans that are right for them.What You’ll Learn From This Episode:01:44 Manual adjudication safeguards client money06:04 Handling appeals and offering highly customized solutions09:34 Defining and explaining plan documents13:06 Resurgence of level-funded plans16:49 Using data for transparency and improved member plansQuotes:03:48 “We consider ourselves to be stewards of their monies and take that very very seriously. So we’re going to put a lot of extra attention and focus on being that that claim has gone through all the appropriate levels of authority before we release those monies.”04:46 “If you’re having an inpatient surgery, we want to be sure that what we call the CPT code, which is a technical term, but basically have the hospital’s billing procedures, we want to be sure that there’s not what we call unbundling.”10:30 “[The plan document] basically is the, we call it the 4 corners of the document that basically sets out all of the benefit structures, what’s covered, what’s not covered, definitions of terms, all of those good things.”14:08 “With a well-designed, level-funded plan, there is the ability to keep reserves versus if they are fully-insured they do not. So that’s a huge change in the industry.”21:00 “Call our company and say, ‘I want to see this piece of data as raw as you can make that for me or as thorough as you can make it or as transparent as you can make it for me because then we’re going to make x, y, z decisions.”

This week’s episode features a conversation with Kari Niblack, CEO at ACS Benefit Services. TPAs now offer novel and customizable plans while still providing traditional services like manual adjudication and appeals. At the same time, TPAs now assist smaller companies who are on level-funded plans to take the leap into partially-self-funded plans. In 2021 and beyond, data and transparency must be used to help clients make more informed decisions on the plans that are right for them.What You’ll Learn From This Episode:<ul><li>01:44 Manual adjudication safeguards client money</li><li>06:04 Handling appeals and offering highly customized solutions</li><li>09:34 Defining and explaining plan documents</li><li>13:06 Resurgence of level-funded plans</li><li>16:49 Using data for transparency and improved member plans</li></ul>Quotes:03:48 “We consider ourselves to be stewards of their monies and take that very very seriously. So we’re going to put a lot of extra attention and focus on being that that claim has gone through all the appropriate levels of authority before we release those monies.”04:46 “If you’re having an inpatient surgery, we want to be sure that what we call the CPT code, which is a technical term, but basically have the hospital’s billing procedures, we want to be sure that there’s not what we call unbundling.”10:30 “[The plan document] basically is the, we call it the 4 corners of the document that basically sets out all of the benefit structures, what’s covered, what’s not covered, definitions of terms, all of those good things.”14:08 “With a well-designed, level-funded plan, there is the ability to keep reserves versus if they are fully-insured they do not. So that’s a huge change in the industry.”21:00 “Call our company and say, ‘I want to see this piece of data as raw as you can make that for me or as thorough as you can make it or as transparent as you can make it for me because then we’re going to make x, y, z decisions.”

Ep #346: Updated Plans Need Up-to-date TPAs - with Kari Niblack

Kari Niblack, President and CEO at ACS Benefit Services, shares her stories of hard work (7 years to complete bachelor’s degree while working full time), persistence (completing a law degree three years later) and a zig-zag career (fell into healthcare) that was always consistent with her beliefs. Armed with an abundance of grit, Kari worked hard to build relationships, listen to her mentor and surround herself with those that believe what she believes. There is too much wisdom in this podcast to list everything…so you’ll just have to listen!Learn more about your ad choices. Visit megaphone.fm/adchoices

Kari Niblack, President and CEO at ACS Benefit Services, shares her stories of hard work (7 years to complete bachelor’s degree while working full time), persistence (completing a law degree three years later) and a zig-zag career (fell into healthcare) that was always consistent with her beliefs. Armed with an abundance of grit, Kari worked hard to build relationships, listen to her mentor and surround herself with those that believe what she believes. There is too much wisdom in this podcast to list everything…so you’ll just have to listen! Learn more about your ad choices. Visit <a href="http://megaphone.fm/adchoices" rel="nofollow" target="_blank">megaphone.fm/adchoices</a>

Kari Niblack - Always Take the Meeting

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See Privacy Policy at <a href="https://art19.com/privacy" rel="nofollow" target="_blank">https://art19.com/privacy</a> and California Privacy Notice at <a href="https://art19.com/privacy#do-not-sell-my-info" rel="nofollow" target="_blank">https://art19.com/privacy#do-not-sell-my-info</a>.

Friday Conversation: Kari Niblack - 10-25-19