Payment Integrity Audits

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We understand the challenges associated with ensuring quality patient care, managing a network of providers, and maintaining a healthy Medical Cost Ratio (MCR). We offer a complete suite of payment integrity services designed for payers looking to get more from their outsourcing partners. Whether you're a large national health plan, local regional plan, or government agency – we have the experience to deliver a payment integrity program tailored to your unique goals and requirements.

Our audit and recovery services offer:

  • Experience from national CMS RAC programs and commercial payers representing more than 90 million covered lives
  • Fast program implementation for accelerated recovery and ROI
  • High accuracy and customer service ratings, with a focus on protecting critical provider relationships
  • Proprietary technology, online program reporting and dedicated teams focused on building long-term partnerships