Medical Claims Audit Firm
Focused Sample Claim Audits
Our Focused Sample Audits identify overpaid medical claims and, if warranted, recovers these overpayments for you.
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Random Sample Claim Audits
We’ll provide you with an objective measurement of the claims payment accuracy of your 3rd Party Administrator (“TPA”) and reduce your benefit plan’s operating expenses.
RX Pharmacy Audits
A MedReview Pharmacy Audit will verify that your prescription drug claims are being paid in accordance with your Pharmacy Benefits Manager (“PBM”) contract.
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Dependent Eligibility Audits
A Dependent Eligibility Audit will audit plan participation to ensure that only eligible dependents are provided coverage on your health plan. Read more
What we do
Testimonial
We contracted with MedReview to complete a focused audit on claims for an 18 month period for our medical carrier. The MedReview team did a great job managing the process, and keeping the carrier on the agreed upon timeline. Once the audit was complete they provided a detailed report, and did a great job working with the carrier to reconcile some differing opinions on the audit results. At the end of the day we ended up recovering about $250,000 from missed processed claims during the audit period. This is a significant return on investment, and is well worth the completing of the audit. We plan to use MedReview for future plan audits, and we plan to make sure audits are done on an annual basis to ensure claims are being processed correctly and not over paid. I would highly recommend MedReview as an audit partner for any organization. They have definitely earned our future business.
Ryan Murry; SPHR, SHRM-SCP
Director; Compensation & Benefits
Essilor of America
Let’s work together
An article in self-funded magazine asked if a self-funded medical plan should audit their claims administrator. Their answer was – perhaps a better question was to ask is: How could they justify not doing so
