Self-Funded Insurance Plan Audits
Think beyond the bottom line.
MCM is one of the only Top 100 accounting firms with the expertise to perform claims accuracy and performance audits. Our national practice has successfully performed more than 300 medical, life, disability, dental, vision, FSA, pharmacy, and workers’ compensation claim audits. Our accounting professionals also bring their unique backgrounds to the process, evaluating not only the present issues, but also the claims payment and process controls.
When is a claims audit right for me?
We recommend all self-funded plans with more than 250 covered lives consider a claims audit if any of the following are needed or present:
Validate your TPA’s performance to contractual and industry standards.
Healthcare spending identification
Identify and mitigate unnecessary healthcare spending.
Verify your processing accuracy for performance guarantees with your TPA.
Transition to a new TPA or make significant changes to the benefits. Supplement your processes by adding additional scrutiny of these significant costs.
Monitor your fiduciary responsibilities
If you want increased governance and monitoring of your fiduciary responsibilities, call us.
Gain access to national expertise without incurring the costs of employment.
Let’s dig in and get to work.
Senior Advisory Manager
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