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Business Situation
At the recommendation of their consultant following concerns about the accuracy of claims adjudication, this employer group approached BMI to conduct an audit of medical and prescription drug claims paid by their third-party administrator.
Solution
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the …
Business Situation
In support of due diligence efforts, a construction industry health and welfare fund approached BMI to conduct a comprehensive audit of 24 months of medical claims paid by their third-party administrator.
Solution
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives:
Business Situation
Every few years this large group of public school districts relies on BMI to conduct a thorough review of medical claims paid by their third-party administrator to ensure the plan’s assets are being used appropriately for the sole benefit of plan participants.
Solution
Utilizing our experienced staff …
Business Situation
BMI was engaged to audit this manufacturer’s new third-party administrator for both their medical and prescription drug plans to ensure benefits were being paid appropriately and to evaluate overall administrative effectiveness.
Solution
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives:
Business Situation
This city government approached BMI to conduct a retrospective audit of medical claims following concerns about proper adjudication.
Solution
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives:
Business Situation
This county government client approached BMI to conduct an audit of medical and prescription drug claims for cost reduction purposes after a significant rise in insurance expenditures.
Solution
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives:
Business Situation
This religious institution began conducting annual external medical claims audits with BMI after their initial audit with BMI discovered claims being paid in conflict with the plan’s intent.
Solution
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives:
Business Situation
This public school district engaged BMI to conduct a pharmaceutical claims audit of their self-insured pharmaceutical plans and pharmacy benefit manager (PBM). In addition, the client also engaged BMI to conduct an on-site rebate audit, as well as a complete contractual financial guarantee audit.
Solution
BMI performed three …
Business Situation:
As one of several cost containment initiatives, this client engaged BMI to conduct an audit of their self-insured medical plan in order to verify the accuracy of claims payments made on their behalf.
Solution:
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives:…
Business Situation:
A labor union elected to conduct a medical claims audit following an unexpected increase in claims dollars compared to the previous year and the discovery of several adjudication mistakes.
Solution:
Utilizing our experienced staff and proprietary AUDiT iQ™ software, BMI set the following objectives: