A complimentary claims assessment is a high-level health check of your claims data. Unlike a full audit, it doesn’t involve re-adjudicating every claim. Instead, it looks for potential areas of risk, errors, and missed savings.
What We Look For
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Eligibility & Payment Errors — Identify potential duplicate claims, ineligible payments, and other obvious discrepancies.
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High-Dollar Claims — Take a closer look at significant claims and categories where errors or overpayments may have a greater financial impact.
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Process Gaps — Review the claims process from initial submission through payment or denial to identify potential inefficiencies or control issues.
The goal is simple: identify where to look, understand the potential opportunity, and determine whether a deeper review makes sense.