waste, fraud, abuse & overcharging is a huge problem for plan sponsors
The Consulting Authority
We Uncover the True Drivers and Cost of Your Healthcare Overcharging; then Recover the Money
Cut Through Complexity. Eliminate Fraud. Take Back Control of Your Healthcare Costs.
We go beyond surface-level analysis. Our team identifies and addresses the root causes of rising healthcare expenses—starting with hospital billing practices, uncovering intermediaries’ markups, auditing all vendors including Brokers and recovering, then eliminating fraudulent overcharging.
Our Approach:
Hospital Billing Forensic Audits – Spot hidden errors, upcoding tactics and inflated charges.
Repricing Your Claim Files – Identifying who overcharged and how much.
Middlemen Analysis – Expose egregious supply chain markups driving up costs.
Vendor Auditing – Identify inherent errors in adjudication and profit taking.
Fraud Detection – Expose and prevent overcharging and misrepresentation.
Recovery – Recapture the money taken in error or by design.
Pharmacy & Rx Consulting – Optimize drug procurement and reduce overspending.
End-to-End Supply Chain Oversight – Ensure every claim dollar is ratified.
Why Collaborate with Us?
Independent & Unbiased – We work only for you, never for insurers, vendors, brokers, or suppliers. Do not rely on internal or self-auditing. Fraud is expertly concealed.
Proven Expertise – Decades of experience in healthcare finance, CAA compliance, and supply chain optimization.
Tangible Results – Immediate recovery. Cost reductions that last.
Who We Serve:
CFOs & Benefits Managers, Government Agencies, Large, Self-Funded Organizations.
Act Today
Stop treating symptoms. Stop overcharging and fraud. Start addressing the root causes of healthcare cost inflation.
evidence based results:
Our work is guaranteed to reduce your Healthcare Spending.
We deliver 100% transparency and perform to a Fiduciary Standard.
You can retain your Broker.
Our fees are 100% Contingency Based.
Planning fulfills Federal ERISA and CAA oversight requirements.
Eliminate overcharging, abuse, and waste - FRAUD!
sample finding:
The employer’s Broker told the CFO their agreement included periodic claim review to ensure that claims were properly priced and paid.
Our method discovered that the TPA’s “claim reviews” and price negotiations were causing overpayments and egregious price gouging that cost the plan and members millions of dollars.
A hernia repair usually costs $1,300 in total. This client paid $57,159.
$29,419 of that went to their TPA for “negotiating a good rate”.
Our method discovered, reported, and recovered 100% of the TPA markup. Additionally, we recovered over $24,000 in hospital upcoding and unbundling tactics.
The client will never pay that much again.