Our end-to-end process provides
full service, before, during, and
after the audit.

We make sure your audit provides the information you need the most and puts it to work.
To achieve that, our comprehensive, end-to-end process starts before the audit and continues after.

Our primary goals are to determine, how well claims are being administered, what sorts of errors are occurring and why, what can be done to eliminate them, and how to help clients make these improvements in a timely fashion.

An equally important goal is to help clients recover claims paid in error. Typically, we are able to help clients recover between $20-35,000 per 1,000 employees, annually. At a minimum, this translates to a budget-neutral audit, plus additional net savings.

Here are the steps in our end-to-end process

Assessment - One size does not fit all

To deliver maximum value, an audit needs a
fact-rich foundation that fully reflects specific
plan attributes.

 

We provide that foundation through

  • Pre-audit fact-finding
  • Assessment of your unique audit needs
Output: A customized 
foundation for each audit
we perform.

Audit - Automated and manual analysis

For over 20 years, we have set the industry
standard for what an audit can, and should, do.

 

  • We developed a proprietary, manual, claims
    review process that eliminates false positives,
    makes strategic sampling choices that purely
    statistical analysis can miss, and ensures that
    sample quality (which translates into cost savings)
    is never compromised to meet sample
    size requirements
Output: Our 100 percent
audit can identify all suspect 
claims, every error, and every
error type, with accuracy that 
is unmatched in our industry.

Action - We help clients leverage audit results to increase ROI

Even the most accurate audits are just numbers if the results are not translated into remedial actions.

Our post-audit advisory activities are geared toward action that will leverage your audit for maximum ROI.

 

We recommend ways to
improve all aspects of claims
administration, based on audit
results and our expertise
We’re experienced at securing
commitments to action from
administrators

Problem-solving, 
from contract terms 
to claims processing
Error detection,
correction,
and prevention
Our team has years of
experience in helping clients
recover dollars lost to error

Process improvements that we can help you achieve after the audit, can yield as much as 1 to 2 percent of total claims paid per year, as specific overpayment categories are pro-actively eliminated.

Output: Better administration, full control over your plan, 
net cost savings and dollar recovery over and above a 
budget-neutral audit.

We seek to minimize your burden, so we use your time carefully.

Typically, we need no more than 2-4 non-consecutive days of our client team’s time per year, per audit.

With the easy to use, standardized audit process, your time involvement will be similar or even less than traditional sample audits.