Recover Lost Funds with our TPA Auditing Services
We can audit
claim activity for accuracy, and reimburse recovered funds
When you choose BRMS as your TPA, we can collect and review your previous TPA's data, audit claim activity for accuracy, and reimburse recovered funds.
Claim procedure auditing on prior administrators determines compliance, assesses timeliness of claims payment, determines monetary penalties, evaluates accuracy of payments, and assesses for potential fraudulent and abusive claim submissions, duplicates and other errors.
An examination of the prior administrator's claim processing procedures includes, but is not limited to:
- Duplicate Payments
- Multiple Surgery Reimbursement
- Incidental/Global Services
- Unbundling/Up-Coding
- Coordination of Benefit Payments
- Medical Necessity
- Anesthesia Paid Incorrectly
- Participating Allowance, Hospital Discounts taken incorrectly
- Technical and Professional Services processed incorrectly
- Non-Covered, Comfort or Excluded Items
- Services that have Dollar and/or Policy Limitation
- Worker's Compensation/Automobile Accident
- Fraud and Abuse
- And more.
Contact Us for more information


