ELIMINATE WASTEFUL HEALTHCARE SPENDING

Payment integrity solutions help employers identify and remove wasteful healthcare spending and improve vendor performance. Our solutions provide actionable information to evaluate past plan performance and provide an enhanced prescription drug audit as well as medical, dental, provider, and dependent eligibility audits.

AUDIT & COMPLIANCE
BenefitsAudit is our health benefits auditing and expense management reporting solution for the self-insured employer. Paired with our cutting-edge data mining, industry-celebrated benchmarks, and consulting support, BenefitsAudit provides immediate and long-term savings to many of America's leading employer groups.
Download the BenefitsAudit brochure PDF

BenefitsWatch is a continuous monitoring solution designed to ensure you get value from critical areas of health plan performance, such as compliance, budget, cost, and utilization. Our proprietary tools, industry expertise, and benchmarking resources enable you to compare your plan's performance to other organizations and identify areas where you can reduce waste.
Download the BenefitsWatch brochure PDF

PHARMACY BENEFIT STRATEGIES
Our Pharmacy Benefit Strategies provide customized services to employers in evaluating, selecting, and contracting with a pharmacy benefit manager (PBM) to streamline pharmacy benefits.
Download the Pharmacy Benefit Strategies brochure PDF

HEALTH PLAN AND VENDOR MANAGEMENT
Our experienced consultants help clients evaluate, select, and manage medical and prescription drug plans, insurers, and vendors, supported by our robust data assets. We conduct:

• Plan performance guarantee audits, comparing reported outcomes to national benchmarks adjusted to accurately reflect the profile of an employer's enrolled population
• Pharmaceutical plan reviews, pinpointing use and cost by vendor, disease category, geography, or drug class or type, and use this information to evaluate current health plan performance, negotiate favorable rates, and strengthen performance guarantees

FINANCIAL SUPPORT
We offer employers tools and support to track annual healthcare expenditures, determine the drivers of year-over-year cost variances, and forecast funding needs. Employers can use this information to align costs with budget and build a foundation for future investment decisions, as well as:

• Improve cash flow management and forecasting based on budget vs. actual expense comparison
• Assure contract compliance of billing and administrative fees with health insurance carrier audits
• Manage future service demand and cost through population health risk analyses
• Prevent denied claims by identifying revenue cycle risk points and improving tracking systems and processes
• Calculate and facilitate collection of the patient portion of required medical services at admission
• Manage patient treatment in compliance with payer contracts