Medical Claims Audits

Many self-insured M&O contractors hire third party administrators (TPAs) to process their claims; however, few M&Os audit their TPAs.  DOL states, "... the employer is required to monitor the service provider periodically to assure that it is handling the plan's administration prudently."  A medical claims audit accomplishes this task.

 We specialize in medical claims audits, providing you with the feedback necessary to assess your TPA's performance. In addition, we identify mispaid claims and work with the third party administrator to recoup erroneous payments,  Email us for a free consultation.