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Take Control of your Plan's Healthcare Spending

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Much More Than an Audit

This isn't an audit, it's a plan fiduciary function. 
Rather than produce a book report on 150 claims, we forensically re-adjudicate every claim you have paid, or will pay, to protect your plan and members.

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Get Back 5-25% of What You Will Spend or Have Spent

We uncover "found money" for plans that they had already written off. What will your health plan do with a multi-million dollar windfall? 

CAA & ERISA Compliance

With plan fiduciaries' ever-increasing obligations under ERISA and the CAA, CI provides our clients safe harbor by ensuring plan and members are only paying what is required.

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No Additional Work For Plans or Members

The CI program is simple to implement: introduce our team to your TPA or carrier, and we'll take it from there. No member involvement, ever.

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Pre-Payment

 ClaimInformatics reviews each claim before it’s paid, to ensure billing and pricing accuracy. This process proactively decreases your plan’s healthcare spend by 10%-25%.

Post-Payment

Even if your plan has improperly paid claims, it’s not too late to identify overpayments and recover plan assets. Using the ClaimIntelligence™ platform to assist with recapturing assets, we respectfully and diligently collect, reconcile and deposit recouped funds. This process recovers 5%-15% of paid plan assets. 

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