Medical Plan Audits

Medical Plan AuditsAt Sinclair Risk & Financial Management, we offer a Medical Plan Audit to help self-funded health plan employer sponsors identify costly errors and improve claims administration processes. Our objective is to provide HR and Benefits Managers with easy-to-understand information when working with claims administrators to reduce expenses and improve the service provided to medical plan participants.
Our comprehensive medical plan audits include:

  • Reviewing claims to ensure that they’re being paid in compliance with both contract terms and plan documents
  • Evaluating the accuracy of payments, including errors, overpayments for recovery, and fraud detection
  • Measuring claims payment accuracy, including identifying and prioritizing costly administrative errors and/or system problems
  • Identifying the causes of errors and weaknesses, and working to correct issues
  • Assisting in contract renewal negotiations
  • Assessing regulatory conformance

Helping to control health care costs.
Employers are looking for ways to keep health care costs down. One solution is through an audit of your health care claims and bills. Sinclair is ready to provide you with this service. Call us at 203.265.0996, email us, or return the form on this page for more information.