Abstract: The invention includes receiving a first data set that includes information associated with claims under a benefit plan. The first data set is searched for a first claim from the claims that includes at least one detail in common with a second claim from the claims. A report including the first claim and the second claim is generated. A duplication of a charge for the first claim or a duplication of charge for the second claim included in a vendor invoice received from a vendor is identified. The invention also includes comparing a first electronic data set that includes information associated with claims paid by a vendor to a provider, to a second electronic data set that includes claims included in a vendor invoice to an employer to determine if a claim from the claims included in a vendor invoice has been included in a claim paid to a provider.

Abstract: Data associated with a benefit plan, including enrollment data and claims data, are compared to verify proper payment of claims. Additionally, other information, such as general ledger, employer account information, and employer organizations can be considered. Information can be output to a user, such as a plan administrator, in a form convenient for that user to quickly understand a large amount of information and how that information relates to a business or other entity administering the benefit plan. Various techniques can be used to estimate reserves, and can optionally use a claims lag triangle as input, including a claims lag report method, a earned premium method, and iterative method, and a regression method, for example.