Medical Claims Auditing

Medical Claims Auditing Insurance

We help self-insured employers uncover and recover overpaid healthcare claims, putting money back into your business. We audit any TPA or claims administrator with a detailed, contingency-based approach, ensuring you only pay for results. Let us help you take control of your healthcare spending and maximize savings.

Contingency Fees
100% Claims Audited
Data Warehouse Claims For trend prediction
Identify Areas For Cost Savings & Efficiency
Negotiate More Favorable Plan Terms

Our Approach is Different From Most Vendors

We don’t utilize a sampling methodology. We perform a comprehensive review of all paid claims using our proprietary audit logic. We’re confident that a comprehensive review is superior to a sampling methodology because it can:

Identify Errors – Identifies all incidences of a particular type of payment error
Validate Findings – Validates the findings of the audit based on specific claims information
Improvement Process – Provides compelling evidence of operational issues at the payer site

A 2% Error Sounds Small…

A company with 1,000 employees can save more than $250,000 in medical claims costs. This can be realized through the identification of a 2% error rate. A 2% error sounds small until it comes out of your employees’ healthcare.