waste, fraud, abuse & overcharging is a huge problem for plan sponsors
The Consulting Authority
Congratulations on your recent renewal — a flat, 0% increase is always good news. You trust your agent and feel comfortable with your plan
You have your agent’s best work.
Cut Through Complexity. Eliminate Fraud. Our complimentary healthcare cost review takes about 20 minutes. When reviewing legacy insurance arrangements paired with legacy pharmacy benefit managers, we find meaningful opportunities to reduce spending — usually 30%, immediatly. Would you choose a six-figure monthly savings today, or forfeit the $1,200,000+ until 01.01.2027?
Our Approach:
Hospital Retrospective Adjudication – Spot hidden errors, upcoding tactics and fraud.
Retrospective Review of Your Claim Files – Identifying who overcharged and how much.
Middlemen Analysis – Expose egregious supply chain markups driving up costs.
Vendor Assessments – Identify inherent errors in adjudication and profit taking.
Fraud Detection – Expose and prevent upcoding and misrepresentation.
Recovery – Recapture the money taken in error or by design. (1,000+ employees)
Pharmacy & Rx Consulting – Optimize drug procurement and reduce overspending. (30%+ Reduction in Cost)
End-to-End Supply Chain Oversight – Ensure every claim dollar is ratified.
CAA Compliance - Plan sponsors must document oversight of TPAs, claim adjudication, hospital billing, brokers, and carriers. (GAG Clause)
You Can Keep Your Agent.
Why Collaborate with Us?
Independent & Unbiased – We work only for you, never for insurers, vendors, or suppliers. Do not rely on internal or self-auditing. Overcharging is expertly concealed.
Proven Expertise – Decades of experience in healthcare finance, CAA compliance, and supply chain optimization delivered to Fiduciary Standards.
Tangible Results – Immediate savings. No Waiting For Renewal. Ongoing Cost reductions.
Who We Serve:
CFOs & Benefits Managers, Government Agencies, Self-Funded Organizations.
This is What You Need to Do as A Plan Sponsor!
Stop overcharging MOVNG FORWARD.
Start addressing the root causes of healthcare increases.
evidence based results:
Our work is guaranteed to reduce your Healthcare Spending. Employers with 250+ employees qualify for the $1,000,000.00 savings guarantee.
We deliver 100% transparency and perform to a Fiduciary Standard.
Stop Overcharging Moving Forward!
Negotiate more favorable contracts with administrators, networks, providers, and Pharmacy Benefit Managers.
You can retain your Broker.
Our fees are 100% Contingency Based.
Solutions are 100% Transparent
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 internal 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. 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.
The client will never pay that much again.