Audit Services

We employ proprietary services and utilize partner vendors to audit claim and eligibility data so that you pay for only what you are obligated to pay. We monitor Medicare eligibility and have access to specialized vendor services around “Social Security Disability” in order to make sure you pay primary only on members you are obligated to pay for as a plan sponsor.

Dependent Eligibility

Design and review eligibility rules to make sure you only cover members you are legally obligated to cover under your healthcare plans.

Medicare Primacy

Retiree legacy liabilities are often enormous. We have over a decade experience developing screening methods to identify retiree members who have failed to secure and maintain Medicare A and B status. Maximize Medicare primary payments; otherwise your plan has unnecessary exposure to high-cost medical claims.

Social Security Disability Primacy

Pre-Medicare retirees are the highest per person cost in your plan. Did you know that some of these retirees may also have access to or could qualify for Medicare disability? We can make sure you have a screening mechanism in place to identify these members and have Medicare pay primary.