Author: TFG Partners, LLC

In today’s inflationary environment, auditing healthcare claims has emerged as a critical concern for large employers with self-funded medical plans. The COVID-19 pandemic significantly amplified the need for medical claim auditors, as the unprecedented expenditures during the pandemic years necessitated thorough reviews of claims. Employers are more aware than ever of the rising instances of…

  In the aftermath of the coronavirus pandemic, reviewing claims with a medical and Rx audit became a more urgent priority. The surge in costs during COVID-19 was unprecedented for many plans, as new tests and services emerged with varying price points. Costs for similar services could differ significantly based on where plan members sought care….