Why Conduct a Medical Claims Audit?

What Does a Claims Audit Actually Involve?


Audit Services Drive Down Costs and Drive Up Compliance

The cost and complexity of benefits plans continues to rise. That means that organizations are under increased pressure to make sure their plans are being managed as efficiently as possible while also staying up with the latest regulatory changes. But even the best organizations rarely have the internal processes in place and deep knowledge to wade through overwhelming volumes of plan information.

Our team of experts understands your benefits plans and the regulatory landscape inside and out. We offer a full range of audit services from claims to compliance to make sure that your plan is cost efficient and meets all legal requirements. An audit may reveal you’re overpaying on claims, or perhaps that you are covering ineligible dependents. Our team will comb through every document and every line of your benefit plans to make sure that you are maximizing value.
Our services include:

  • Day-to-day audit support
  • Claims administration and dependent enrollment audits
  • Compliance audits and reviews
  • HIPAA audits
  • Educational events, seminars and onsite training