Find what your health plan overpaid. Pay 20% of what we recover, $0 upfront.
Self-funded plans pay claims with duplicate charges, unbundled codes, and prices far above Medicare. We audit your claims file, show you what’s recoverable, and pursue it with your TPA. If nothing is recovered, you pay nothing.
What the report looks like
Example output from a batch of claims. Your numbers depend on your data.
| Finding | What it means | Example amount |
|---|---|---|
| Duplicate claims | Same code, member, provider and date, paid twice | $21,400 |
| Unbundled codes | Component codes paid alongside the comprehensive code (NCCI edits) | $15,020 |
| Pricing outliers | Paid above 400% of Medicare. Renegotiation leverage, reported separately | $12,700 |
Recoverable amounts are billing errors your plan paid. Pricing outliers are reported separately, because paying above Medicare is not an overpayment unless your provider contract says so.
20% contingency. No recovery, no fee.
Send a claims extract (CSV) through a secure transfer after we sign a BAA. We run the audit, you review the findings, and we only invoice on amounts actually recovered.
- Your plan keeps
- $80,000
- Our 20%
- $20,000
- If we recover nothing
- $0
For every $1 you pay us, your plan keeps $4. You pay nothing upfront.
How a pilot works
Sign a BAA
Plus a scope agreement covering which claims, the lookback period your provider contracts allow, and how recoveries are handled.
Send your claims
A CSV extract from your TPA with claim ID, member ID, provider NPI, date of service, code, units, billed and paid.
Review the findings
Every flagged line with the rule behind it. You decide what to pursue, and we only invoice on what’s recovered.
- We sign a Business Associate Agreement before seeing any claims
- Audit records encrypted at rest with AES-256