Recovery Audit Specialists - Moody Associates, P. A.

Estimate Request Form

To obtain a free estimate of the recovery opportunity at
your organization, complete the following form and submit.

Accounts Payable / Vendor Information

Annual amount of health care claims:
Number of claims processed:
Who is your current TPA?
Where are the claims records located?
How are claims records filed?
Has there been a change in TPA’s?
If so, who was the prior TPA?
Any current plans to change TPA’s?
If so, when?
Number of employees covered
Number of plan options (HMO, PPO, etc.)
Has there been a prior claims audit completed?
If so, what firm?
What period was audited?
What were the findings?

Notes: