April 21, 2025 • 11 mins
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.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Hey, thank you for listening into Risky Benefits, a podcast
that informs you on all thingsbenefits.
We've got a saying around here,benefits isn't your main
business.
It's ours.
farris_1_02-27-2025_131438 (00:16):
Hey everyone.
Thank you for listening to RiskyBenefits and welcome to this
week's episode.
Our returning guest this week isEmily faa.
Emily is our Vice President ofClient Administration.
Hi.
And we had Emily on last year todiscuss our specialty billing
services and we enjoyed talkingwith her so much that we wanted
(00:37):
to have her back to learn moreabout the other things that our
team does, specificallyconsolidated billing and
reconciliation.
And let's just like address theelephant in the room.
Nobody listening to this, withthe exception of just a mere few
know what that.
Even means, nor probably shouldthey, I would venture to say,
(00:58):
did know what it meant.
Like something bad happened andprobably your insurance policies
weren't getting paid for, and itwas a catastrophe.
So.
We're gonna talk about it'causeit's highly important.
But the joke of it is, ishopefully you never have to hear
about it.
'cause people like Emily do sucha good job that like there's no
reason for you to know what'sgoing on.
'cause it all happens behind thescenes of the insurance products
(01:21):
that you have to protect you andyour families.
But it's good for you tounderstand it in case something
does go wrong and or so you canhave a full appreciation of the
people that provide yourservices.
So without further ado, Emily,you for coming on again.
squadcaster-03ba_1_02-27- (01:37):
Thank you for having me back.
farris_1_02-27-2025_13143 (01:39):
Yeah, it's great to have you.
Let's start by giving thelisteners a recap, just a little
bit about who you are what youdo for the team, just as a
reminder.
squadcaster-03ba_1_02-27- (01:47):
Yeah, so, Emily Ola vice President of
Client Administration.
So I oversee our team thathandles our TPA services and our
call center.
And like you mentioned, the lasttime I was on here, we talked
about our specialty billing.
So direct billing.
Um, members.
Members.
And today I'm excited'causewe're going to talk about
another service that we offer.
(02:08):
And this is for our clients whodeduct premiums through payroll.
So I'm excited to talk aboutthis.
I'm probably the only one who'sexcited.
farris_1_02-27-2025_131438 (02:17):
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 theobvious.
Billing and reconciliation are anightmare.
When you're dealing withmultiple vendors and service
providers you can get buriedwith invoices, payment firms,
tracking payments, et cetera.
(02:38):
It can be tedious andinefficient.
How does your team work with ourclients to help reduce this
headache?
squadcaster-03ba_1_02-27- (02:44):
Yeah, so Kila, you nailed it.
I mean, that's exactly why weprovide this service.
We wanna take the burden off ofthose payroll HR and even
accounting teams when we'retalking about multiple payments
go into the different carriers.
So this can be very timeconsuming.
So think about an employee's oremployer's benefit package with
(03:04):
all the products, all thedifferent carriers.
They all have their own uniquebilling cycles.
They have their own way ofactually getting invoices to the
client.
So some email them, some youhave to log onto their portal
and grab them.
So it creates a level of chaoswhen you're trying to just
gather all the details.
farris_1_02-27-2025_131438 (03:24):
So when you say Emily, when you say
them, are you talking about thecarriers?
squadcaster-03ba_1_02-27-2 (03:29):
yes,
farris_1_02-27-2025_13143 (03:30):
Okay.
Okay.
squadcaster-03ba_1_02-27-20 (03:31):
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 requiredifferent forms of backup with
those payments.
So that's falling on the clientto figure out, okay, how do we.
Get this backup to them in theway that they need so it can
become a full-time job and very,very time consuming.
(03:53):
So if you partner with us, whatwe do we take all of the
enrollment elections regardlessof carrier.
We consolidate those into onenice invoice provide that to the
client, and they get to pay onetime.
So they're paying funds to usone time instead to the multiple
carriers.
We take those funds and we remitthem on their behalf.
(04:14):
So we're also taking care of thebackend stuff too, that, that
remittance detail, that backupdocumentation as well.
farris_1_02-27-2025_1314 (04:22):
That's awesome.
So I'm assuming, if I were toask, the advantages of using
your team for these services,it's gonna tie into basically
reduced work on the HRdepartment.
How might you address that?
Like what, why would somebodywant to utilize your services
beyond the obvious of justmanaging the process you just
spoke of?
squadcaster-03ba_1_02-27-2 (04:42):
Yeah I mean, we have the best team
too.
So that's the obvious, right?
We're phenomenal.
No but seriously, we do, we havethe best team.
They know their role in this.
So this goes all the way down toa member having access to their
benefits.
We understand that premium reminutes is a huge part of that.
So we take our job veryseriously.
(05:03):
We wanna make sure those fundsare passed to the carriers so
that they have access to, totheir benefits when they need
them.
So that's one that's theobvious, right?
The second is obviously theinvoicing that we just talked
about, but we actually take itone step further.
So we also provide areconciliation service.
So after each payroll we ask fora deduction register.
(05:26):
We receive that deductionregister, and we reconcile back
to the enrollment system as wellas the carriers.
So if we have a list billsituation so we are doing this
on a monthly basis.
We're identifying thosediscrepancies in payroll,
letting our client know whatthose are so they can take care
of'em on their next payrollcycle.
(05:48):
If they were not using us, thenthey would not they would be
having to identify thosediscrepancies themselves.
So again, we're taking work offof them.
farris_1_02-27-2025_131438 (05:58):
And so Emily, you you're licensed
and registered as a TPA in amultitude of states.
That then means that you'reessentially a fiduciary on for
the services that you provide,and that in and of itself means
that there's some kind of weightto the service you're providing.
squadcaster-03ba_1_02-27-20 (06:16):
No, that's correct.
And we are licensed in all 50states so that we can provide
these services anywhere.
Another thing I wanna mentionthat I think is critical we do
this on a monthly basis.
So we mentioned the team beingable to take care of their
payroll or take care, care ofany discrepancies on their next
payroll cycle.
But I think more importantlywe're looking at the big
(06:37):
picture.
So a lot of times we seebusinesses that they don't find
there's an issue until the endof 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 thecarriers, but we haven't been
collecting or deducting fromthose members the correct
(06:58):
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 theseservices on a monthly basis, we
reduce that and try to help themkeep their books in alignment.
No one ever wants to go back toa member at the end of the year
as an employer and tell them wedidn't deduct from your paycheck
(07:21):
correctly, and now we've gottacollect.
I mean, that's no conversationthat anyone wants to have.
So it's really important,
farris_1_02-27-2025_13143 (07:28):
Yeah, because I guess you'd get
yourself into a scenario wherethe employee may be like, well,
I can't afford to have thattaken outta my paycheck.
I gotta have, I gotta drop thispolicy or something like that.
Yeah.
Then if something catastrophichappens and they didn't have the
coverage, now they're them andtheir family are really in a bad
way.
It stands to reason that.
One would want to keep it'sprobably should be best case
(07:52):
business practice.
squadcaster-03ba_1_ (07:53):
Absolutely.
farris_1_02-27-2025_13143 (07:55):
Yeah.
Or the business standard Iguess.
Yeah.
Emily, you mentioned somethingyou said that you reconcile with
the enrollment systems.
Do you guys have any limitationson what systems.
squadcaster-03ba_1_02-27-202 (08:07):
We do not have limitations with
systems.
So we've built our process wherewe can actually support any
system.
And so we worked duringimplementation to, to figure out
how we're going to gather thatdata.
But we do not have a limitationwith systems, so thank you for
asking that.
farris_1_02-27-2025_13143 (08:23):
Yeah, so is there any specific group
type or size that could benefitmost from this type of service?
squadcaster-03ba_1_02-27-20 (08:30):
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 anemployer, let's say 200 and
below lives those employers are,when you really look at a
staffing structure.
you may have one person who'swearing many hats, you may have
one person who is payroll,they're accounting, they're also
(08:53):
hr, and they really can utilizesome help in these areas.
So I mean, really we can supportboth up and downstream.
It's just depends on theclient's needs.
farris_1_02-27-2025_1314 (09:04):
That's cool.
How about success stories?
Any that you'd like to share?
I.
squadcaster-03ba_1_02-27- (09:08):
yeah.
One that comes to mind I wouldsay is a group.
They were about.
Probably seven 50 lives.
They joined us.
We took over their billing andreconciliation and within the
first month we were actuallyable to identify a substantial
amount of discrepancies.
And they were anywhere frompaying for members who had
(09:29):
already terminated to people whochange plans.
And with our help, we were ableto help them recoup around
$50,000 that they had beenpaying.
farris_1_02-27-2025_1314 (09:39):
that's a significant chunk of change.
squadcaster-03ba_1_02-27-2 (09:41):
Yes.
farris_1_02-27-2025_131438 (09:44):
is there anything else that makes
our solution different fromothers?
squadcaster-03ba_1_02-27-2025 (09:48):
I would say the biggest piece is
the reconciliation that we justtalked about, the payroll
reconciliation.
I.
So, consolidated invoicing orbilling, however you refer to
it, it's in the market, it'savailable pretty much any TPA
out there is going to offer thatservice.
Where we differ is in thereconciliation piece.
So others may say they perform areconciliation and typically
(10:11):
what they're doing is like apercent margin or they have a
certain threshold that isagreeable and so they reconcile
that way.
But we truly reconcile down tothe member level.
So every dollar that comes intoour department, every penny
we're accounting for that andmaking sure it's routed to the
appropriate location.
So we're good stewards of thosefunds.
farris_1_02-27-2025_1314 (10:32):
That's awesome.
Well, Emily I really don't thinkthat there's too much more that
we planned on getting into.
I think this gives like a goodsummation or kind of coverage of
what it's, that you guys aredoing.
But I do wanna say just kind ofa final question for you, which
is there anything else that.
squadcaster-03ba_1_02-27-2025 (10:49):
I think I would like to share just
you know, stats or maybe givethe listeners an idea of volume
of what we handle each month.
I think it shows how streamlinedand efficient our process is.
So just for the service alone,each month we're reconciling for
around 115,000 plus lives andaround$23 million in premium.
farris_1_02-27-2025_1314 (11:09):
That's awesome.
Well, we're certainly gratefulthat you do it.
I know our clients are.
For those of you who are outthere listening we'd love to
hear from you if this issomething you're interested in.
Emily, thank you very much forcoming on today.
squadcaster-03ba_1_02-27- (11:22):
Thank you for having me.
farris_1_02-27-2025 (11:23):
Absolutely, and thank you to the listeners
out there.
Just know if you have anyquestions.
Please contact us or look forinformation on our
website@www.fbmc.com.
And remember, you can find usand subscribe on any podcast
app.
Thanks and have a great day.
Hey, thank you for listening into Risky Benefits, a podcast
that informs you on all thingsbenefits.
We've got a saying around here,benefits isn't your main
business.
It's ours.
farris_1_02-27-2025_131438 (00:16):
Hey everyone.
Thank you for listening to RiskyBenefits and welcome to this
week's episode.
Our returning guest this week isEmily faa.
Emily is our Vice President ofClient Administration.
Hi.
And we had Emily on last year todiscuss our specialty billing
services and we enjoyed talkingwith her so much that we wanted
(00:37):
to have her back to learn moreabout the other things that our
team does, specificallyconsolidated billing and
reconciliation.
And let's just like address theelephant in the room.
Nobody listening to this, withthe exception of just a mere few
know what that.
Even means, nor probably shouldthey, I would venture to say,
(00:58):
did know what it meant.
Like something bad happened andprobably your insurance policies
weren't getting paid for, and itwas a catastrophe.
So.
We're gonna talk about it'causeit's highly important.
But the joke of it is, ishopefully you never have to hear
about it.
'cause people like Emily do sucha good job that like there's no
reason for you to know what'sgoing on.
'cause it all happens behind thescenes of the insurance products
(01:21):
that you have to protect you andyour families.
But it's good for you tounderstand it in case something
does go wrong and or so you canhave a full appreciation of the
people that provide yourservices.
So without further ado, Emily,you for coming on again.
squadcaster-03ba_1_02-27- (01:37):
Thank you for having me back.
farris_1_02-27-2025_13143 (01:39):
Yeah, it's great to have you.
Let's start by giving thelisteners a recap, just a little
bit about who you are what youdo for the team, just as a
reminder.
squadcaster-03ba_1_02-27- (01:47):
Yeah, so, Emily Ola vice President of
Client Administration.
So I oversee our team thathandles our TPA services and our
call center.
And like you mentioned, the lasttime I was on here, we talked
about our specialty billing.
So direct billing.
Um, members.
Members.
And today I'm excited'causewe're going to talk about
another service that we offer.
(02:08):
And this is for our clients whodeduct premiums through payroll.
So I'm excited to talk aboutthis.
I'm probably the only one who'sexcited.
farris_1_02-27-2025_131438 (02:17):
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 theobvious.
Billing and reconciliation are anightmare.
When you're dealing withmultiple vendors and service
providers you can get buriedwith invoices, payment firms,
tracking payments, et cetera.
(02:38):
It can be tedious andinefficient.
How does your team work with ourclients to help reduce this
headache?
squadcaster-03ba_1_02-27- (02:44):
Yeah, so Kila, you nailed it.
I mean, that's exactly why weprovide this service.
We wanna take the burden off ofthose payroll HR and even
accounting teams when we'retalking about multiple payments
go into the different carriers.
So this can be very timeconsuming.
So think about an employee's oremployer's benefit package with
(03:04):
all the products, all thedifferent carriers.
They all have their own uniquebilling cycles.
They have their own way ofactually getting invoices to the
client.
So some email them, some youhave to log onto their portal
and grab them.
So it creates a level of chaoswhen you're trying to just
gather all the details.
farris_1_02-27-2025_131438 (03:24):
So when you say Emily, when you say
them, are you talking about thecarriers?
squadcaster-03ba_1_02-27-2 (03:29):
yes,
farris_1_02-27-2025_13143 (03:30):
Okay.
Okay.
squadcaster-03ba_1_02-27-20 (03:31):
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 requiredifferent forms of backup with
those payments.
So that's falling on the clientto figure out, okay, how do we.
Get this backup to them in theway that they need so it can
become a full-time job and very,very time consuming.
(03:53):
So if you partner with us, whatwe do we take all of the
enrollment elections regardlessof carrier.
We consolidate those into onenice invoice provide that to the
client, and they get to pay onetime.
So they're paying funds to usone time instead to the multiple
carriers.
We take those funds and we remitthem on their behalf.
(04:14):
So we're also taking care of thebackend stuff too, that, that
remittance detail, that backupdocumentation as well.
farris_1_02-27-2025_1314 (04:22):
That's awesome.
So I'm assuming, if I were toask, the advantages of using
your team for these services,it's gonna tie into basically
reduced work on the HRdepartment.
How might you address that?
Like what, why would somebodywant to utilize your services
beyond the obvious of justmanaging the process you just
spoke of?
squadcaster-03ba_1_02-27-2 (04:42):
Yeah I mean, we have the best team
too.
So that's the obvious, right?
We're phenomenal.
No but seriously, we do, we havethe best team.
They know their role in this.
So this goes all the way down toa member having access to their
benefits.
We understand that premium reminutes is a huge part of that.
So we take our job veryseriously.
(05:03):
We wanna make sure those fundsare passed to the carriers so
that they have access to, totheir benefits when they need
them.
So that's one that's theobvious, right?
The second is obviously theinvoicing that we just talked
about, but we actually take itone step further.
So we also provide areconciliation service.
So after each payroll we ask fora deduction register.
(05:26):
We receive that deductionregister, and we reconcile back
to the enrollment system as wellas the carriers.
So if we have a list billsituation so we are doing this
on a monthly basis.
We're identifying thosediscrepancies in payroll,
letting our client know whatthose are so they can take care
of'em on their next payrollcycle.
(05:48):
If they were not using us, thenthey would not they would be
having to identify thosediscrepancies themselves.
So again, we're taking work offof them.
farris_1_02-27-2025_131438 (05:58):
And so Emily, you you're licensed
and registered as a TPA in amultitude of states.
That then means that you'reessentially a fiduciary on for
the services that you provide,and that in and of itself means
that there's some kind of weightto the service you're providing.
squadcaster-03ba_1_02-27-20 (06:16):
No, that's correct.
And we are licensed in all 50states so that we can provide
these services anywhere.
Another thing I wanna mentionthat I think is critical we do
this on a monthly basis.
So we mentioned the team beingable to take care of their
payroll or take care, care ofany discrepancies on their next
payroll cycle.
But I think more importantlywe're looking at the big
(06:37):
picture.
So a lot of times we seebusinesses that they don't find
there's an issue until the endof 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 thecarriers, but we haven't been
collecting or deducting fromthose members the correct
(06:58):
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 theseservices on a monthly basis, we
reduce that and try to help themkeep their books in alignment.
No one ever wants to go back toa member at the end of the year
as an employer and tell them wedidn't deduct from your paycheck
(07:21):
correctly, and now we've gottacollect.
I mean, that's no conversationthat anyone wants to have.
So it's really important,
farris_1_02-27-2025_13143 (07:28):
Yeah, because I guess you'd get
yourself into a scenario wherethe employee may be like, well,
I can't afford to have thattaken outta my paycheck.
I gotta have, I gotta drop thispolicy or something like that.
Yeah.
Then if something catastrophichappens and they didn't have the
coverage, now they're them andtheir family are really in a bad
way.
It stands to reason that.
One would want to keep it'sprobably should be best case
(07:52):
business practice.
squadcaster-03ba_1_ (07:53):
Absolutely.
farris_1_02-27-2025_13143 (07:55):
Yeah.
Or the business standard Iguess.
Yeah.
Emily, you mentioned somethingyou said that you reconcile with
the enrollment systems.
Do you guys have any limitationson what systems.
squadcaster-03ba_1_02-27-202 (08:07):
We do not have limitations with
systems.
So we've built our process wherewe can actually support any
system.
And so we worked duringimplementation to, to figure out
how we're going to gather thatdata.
But we do not have a limitationwith systems, so thank you for
asking that.
farris_1_02-27-2025_13143 (08:23):
Yeah, so is there any specific group
type or size that could benefitmost from this type of service?
squadcaster-03ba_1_02-27-20 (08:30):
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 anemployer, let's say 200 and
below lives those employers are,when you really look at a
staffing structure.
you may have one person who'swearing many hats, you may have
one person who is payroll,they're accounting, they're also
(08:53):
hr, and they really can utilizesome help in these areas.
So I mean, really we can supportboth up and downstream.
It's just depends on theclient's needs.
farris_1_02-27-2025_1314 (09:04):
That's cool.
How about success stories?
Any that you'd like to share?
I.
squadcaster-03ba_1_02-27- (09:08):
yeah.
One that comes to mind I wouldsay is a group.
They were about.
Probably seven 50 lives.
They joined us.
We took over their billing andreconciliation and within the
first month we were actuallyable to identify a substantial
amount of discrepancies.
And they were anywhere frompaying for members who had
(09:29):
already terminated to people whochange plans.
And with our help, we were ableto help them recoup around
$50,000 that they had beenpaying.
farris_1_02-27-2025_1314 (09:39):
that's a significant chunk of change.
squadcaster-03ba_1_02-27-2 (09:41):
Yes.
farris_1_02-27-2025_131438 (09:44):
is there anything else that makes
our solution different fromothers?
squadcaster-03ba_1_02-27-2025 (09:48):
I would say the biggest piece is
the reconciliation that we justtalked about, the payroll
reconciliation.
I.
So, consolidated invoicing orbilling, however you refer to
it, it's in the market, it'savailable pretty much any TPA
out there is going to offer thatservice.
Where we differ is in thereconciliation piece.
So others may say they perform areconciliation and typically
(10:11):
what they're doing is like apercent margin or they have a
certain threshold that isagreeable and so they reconcile
that way.
But we truly reconcile down tothe member level.
So every dollar that comes intoour department, every penny
we're accounting for that andmaking sure it's routed to the
appropriate location.
So we're good stewards of thosefunds.
farris_1_02-27-2025_1314 (10:32):
That's awesome.
Well, Emily I really don't thinkthat there's too much more that
we planned on getting into.
I think this gives like a goodsummation or kind of coverage of
what it's, that you guys aredoing.
But I do wanna say just kind ofa final question for you, which
is there anything else that.
squadcaster-03ba_1_02-27-2025 (10:49):
I think I would like to share just
you know, stats or maybe givethe listeners an idea of volume
of what we handle each month.
I think it shows how streamlinedand efficient our process is.
So just for the service alone,each month we're reconciling for
around 115,000 plus lives andaround$23 million in premium.
farris_1_02-27-2025_1314 (11:09):
That's awesome.
Well, we're certainly gratefulthat you do it.
I know our clients are.
For those of you who are outthere listening we'd love to
hear from you if this issomething you're interested in.
Emily, thank you very much forcoming on today.
squadcaster-03ba_1_02-27- (11:22):
Thank you for having me.
farris_1_02-27-2025 (11:23):
Absolutely, and thank you to the listeners
out there.
Just know if you have anyquestions.
Please contact us or look forinformation on our
website@www.fbmc.com.
And remember, you can find usand subscribe on any podcast
app.
Thanks and have a great day.
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