Medical benefit claims will likely be the most significant component of expenses for your health plan. Plan Third Party Administrators (TPAs), can inadvertently put your organization at risk by processing or paying claims incorrectly. Routinely auditing your medical benefit claims is the best way to ensure that your plan is being administered appropriately. Our professionals can help you to gain the assurance that you need.
Over the past fifteen years, StoneBridge has audited some of the country’s largest healthcare organizations, including health insurers and every major Pharmacy Benefit Manager (PBM) and Third Party Administrator (TPA). Through the audit process we can help your organization ensure that you are fulfilling your fiduciary duty by identifying:
- Duplicate claims payments
- Improper provider reimbursement
- Erroneous claims processing
- Inappropriate coordination of benefits
- Process and internal control improvements
Our audits are customized to the contracts we are auditing. We don’t believe in a “one solution fits all” philosophy. By leveraging the experience we have gained in auditing insurance companies, PBMs, TPAs, and health care providers for corporate clientele, we offer a unique perspective to self-insured plans offering unparalleled knowledge of the contracts that were negotiated.
StoneBridge has helped organizations all over the U.S. for over two decades
Concerned about your self-insured health plans? Gain assurance, contact us today to discuss customizing an audit solution to your needs.
To learn more about our benefit plan audits, please contact us today: