The Financial Management System contains all employers, employees, individuals and dependents that have been converted to membership along with their associated brokers. This system manages the recurring billing cycles, payment processing, commission distribution and cash receipts.
Mosaic Insurance Exchange has two reconciliation methods in place― electronic and manual ―for health insurance plans that transmit electronic billing invoices to our organization.
For electronic reconciliations, the health insurance plan or state agency submits a monthly enrollment file that is uploaded and compared to Mosaic Insurance Exchange’s enrollment and payment records. An audit file report identifying discrepancies is generated and transmitted to the health plan or state agency for review and resolution.
For manual reconciliations, every month Mosaic Insurance Exchange analyzes and verifies all health insurance plan invoices to enrollment, accounts payable, and accounts receivable records to ensure that there are no enrollment transaction and/or premium discrepancies.
All enrollment transactions and premium discrepancies are documented, and the health insurance plan is contacted within two business days to discuss the method and timeframe for resolution.
Mosaic Insurance Exchange has successfully passed each health insurance plan audit without incident for over twenty five (25) years.