Claims Audit

Reviewing the entire claims process to ensure accuracy at every step.

Claims audits are an effective action plan that eliminates waste and adds value to your bottom line.


 

Defend yourself against the costly inaccuracies in claims processing. Amwins Benefit Watch® reviews the entire claim process – from patient to provider to insurance carrier. When we’re done, you will have an effective action plan that eliminates waste and adds value to your bottom line, potentially recovering historical money owed. 

Benefit Watch® reviews 100% of your claims associated with your company’s medical benefits, including

  • Mechanical duplicates
  • Clinical and procedural duplicates
  • Self-funded Medicare gap
  • Assistant surgeon overpayment
  • Single event
  • Bi-lateral and multiple conditions
  • Procedural rate variations

Ballooning pharmacy costs combined with consistent upward trends in usage can impact your ability to grow and stay competitive. Benefit Watch delivers the expertise to control the complex web of therapies, pharmacists, pharmacy benefits and pharmacy benefit managers.

Why Benefit Watch®?

Benefit Watch® reviews 100% of your claims associated with your company’s pharmacy benefits, including:

Pricing

Fees (dispensing, claim, administrative)

Claims basis determination

Claims summary

Billing - drug cost and fees

Co-payments

Exclusions

Eligibility

Prescriptions filled too soon

Unsupported therapy

Maximum daily dosing

 

 

Get in touch

Interested in learning more but not sure where to start? We make it easy. Simply fill out the form below and one of our relationship managers will personally follow up. 

 

 

 

 

Recent Group Benefits Headlines