Medical Claims Audit

While we are not attorneys and we do not approach this aspect of our work from a legal perspective, our work does result in resolution of disputed claim payments via our Healthcare Auditing Services. This applies in instances where a reimbursement source, i.e. insurer refuses to pay a claim while questioning clinical and/or rate legitimacy which may contradict acceptable standards.

Our work extends to:

  • Examining the claim.
  • Researching to justify the amount billed.
  • Researching to opine on Legitimacy of Medical Services.
  • Managing all insurer communications.
  • Managing all Regulatory Complaint, i.e. Department of Insurance & Financial Services

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