Aggregate Claim Audits

• Our dedicated team of auditors will ensure each claim paid was allowable by the master plan document, paid according to the negotiated terms of the PPO or our negotiated rates, ​the disclosure was properly completed, and members were eligible when incurred.

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Claim Cost Negotiating

• The AMC negotiation team consists of highly trained negotiators equipped with a copious amount of medical claims data and medical pricing algorithms used to achieve ​the deepest discounts possible for your plan.  We can negotiate both in and out-of-network claims.

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Medical Review Reporting

• Our clinician team reviews the disclosure, medical questionnaires, claims data, large case management reports, Rx reporting, and physician notes to determine ​potential laser amounts, expected claim volume, and more.  This information is extremely beneficial for the underwriting process.​

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1094/1095 IRS Reporting​​​​

• Our auditors prepare the dreaded end-of-year tax forms required by the IRS from any employer sponsoring a health plan.

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