Health Care Claims Audit Services
With health care costs increasing dramatically each year, self-insured companies should ensure that their claims administrator is not overpaying claims.
Moody Associates, P.A. performs retrospective reviews of health care claims to ensure that their claims administrator is paying claims accurately. We review 100% of your claims payments as far as 3 years back to identify overpayments and assist you in recovery efforts.
Our audits are tailored to your needs and scoped out accordingly.
Our review will likely result in recoveries of overpaid claims, but more importantly will highlight systemic problems that require change in order to reduce future overpayments.
Following is a selection of errors we typically encounter:
• Coordination of benefits errors
• Duplicate claims payments
• Eligibility issues
• Overpaid administrative fees based upon flawed enrollment figures
• Ineligible benefits/services
• Coinsurance and deductible errors
• Incorrect rates/fees
• Unbundled payments
• Coding errors
• Stop Loss oversight
Audit Cost: There is no net cost to you. Moody Associates works on a contingent fee basis. We do not get paid unless you do.
Contact us today to discuss how we can save you money with our Medical Claims Audit.
Associated information:
Audit Recovery
Contract Compliance Audits
Unclaimed Property Consulting
Consulting Services
Pharmacy Benefit Management Audit
