Our Services
Claim Review and Analysis
Our SIU teams review and analyze healthcare claims to identify irregularities, potential fraud, or overpayments. This involves scrutinizing claims data and documents for inconsistencies.
Claim Investigations
We conduct investigations to delve deeper into suspicious claims. This may involve collecting evidence, interviewing parties involved, and working closely with law enforcement if necessary.
Provider Audits
Our SIU may conduct audits of healthcare providers to ensure they are billing accurately and in compliance with contractual agreements.
Data Analysis
We use advanced data analytics to identify patterns and anomalies in claims data that could be indicative of fraud or overpayment.
Policy Development
Help in developing and implementing policies and procedures to prevent fraud and streamline the claims process
Reporting and Documentation
Detailed reporting and documentation of investigations, findings, and actions taken for compliance and audit purposes.