MedReview is One of the Leading Medical Claims Auditors in the Country
Our Medical Claims Audits, Pharmacy Audits and Dependent Eligibility Audits Help Self Insured Plan Sponsors Reduce Their Healthcare Costs


Organizations that self insure their health plans are experiencing double digit cost increases. Health plan costs are now one of their largest operating expenses. MedReview's medical claims audits and our dependent eligibility audit programs will help you control your self insured plan's expenses and will result in a positive contribution to your organization's bottom line. MedReview's medical claims audits will also help you comply with ERISA, Sarbanes-Oxley and other regulatory requirements that mandate you act in the best interests of your plan's participants.

 

MedReview provides a full range of healthcare claims and dependent eligibility audit services.

 

MedReview's audits:

 

  • Identify and recover overpaid claims.
  • Monitor claims payment accuracy.
  • Verify that systems and processes are in place that will maximize the claims paying performance of the sponsor's Third Party Administrator.
  • Help plan sponsors measure how effectively their plan is being administered and to determine if their Third Party Administrator is operating within industry standards.
  • Help plan sponsors evaluate their pharmacy benefits program to determine if their prescription claims are being paid in accordance with their PBM contract.
  • Help plan sponsors validate that all dependents in their benefit plan qualify for plan coverage.

 

 

 

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