Your Healthcare Focus

Continuous Monitoring

Our continuous monitoring audit solution provides early detection of unusual utilization patterns and potential issues, as well as assessing compliance with plan design. By assessing 100-percent of claims on an ongoing basis, we can proactively identify and correct errors — and minimize wasteful spending.

Throughout the calendar year, we apply proprietary analysis and business rules that are generated from your plan design documents and industry standards. Quarterly reports are provided in an easy-to-read format with findings, analysis, and a list of areas for further investigation.

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 Two Minutes to Claims Auditing
Marie Bowker, Senior Director of Practice Leadership

Two Minutes to Payment Integrity
Jean MacQuarrie, Vice President, Payment Integrity Solutions