Claims Audit

Double-digit medical inflation, big hospital bills, skyrocketing prescription drug costs, the risk of self-insuring and Sarbanes-Oxley are motivating employers to measure the performance of third party administrators and pharmacy benefit managers. We answer the questions:

•   How do you know whether all of the claims paid are for your employees and dependents?

•   Is your TPA efficiently handling subrogation and coordination of benefits situations for you?

•   Is our claim payment lag appropriate?