In addition to our traditional auditing reviews we provide more in depth Operational Audits which may involve data, financial and process mapping, and can include the following considerations:

• Organizational and functional reviews including staff analysis, workflow, file support and assignment procedures
• Review authority and reporting levels
• Systems and data processing procedures along with a review of data accuracy
• Our audits will reveal how well claims are documented, including claim payments and reserves
• Analyze the current claims organization with respect to client service, cost reduction and claims delivery
• Audit Medical bills to identify duplicates, state fee schedule compliance, and the over utilization of services
• Review and analysis of Litigation Management procedures and results
• Reconciliation of loss data to ensure financial accuracy, elimination of improper claims and incorrect charges
• Review loss funding arrangements with TPAs
  
• Analyze claim opening / closing activity to eliminate potential reserve redundancy
• Review contracts to improve data supplied by the TPA, reduce service fees and loss fund escrow levels
  
• Conduct operational and financial reviews of TPAs to ensure data integrity
  
• Statistically benchmark each function of the claim handing process, including final settlement in order to provide an overall leakage assessment