The compliance and administrative burdens on employer-sponsored health plans and healthcare providers are immense. Understanding what payments, denials or coding may contain errors is a real headache. The professionals of TMDG
, a PBMares affiliate, can help you better understand and reduce your risks.
Using proven methodologies, our experts look at your organization’s risk management processes. They identify, target, assess and mitigate key risks within the claim cycle for the purpose of safeguarding assets. For employer-sponsored health plans, our professionals conduct:
- Risk-based audits
- Electronic claims audits
- Statistical claims audits
- Operational reviews
- Focused claims audits