Claims Audit
Verify Every Payment. Recover What's Owed.
Traditional audits sample a fraction of claims and miss most errors. We verify every historical payment against your contracts — identifying overpayments, underpayments, and missed recoveries with full traceability.
Your Claims
8
Issues Found
$2.3M
Recoverable
The Problem
Most Errors Never Get Checked
Traditional audits sample 5% of claims and assume the rest is fine. But payment errors aren't random — they're systematic.
Traditional Sampling
5% of claims reviewed
$420K
recovered
Full Verification
100% of claims verified
$2.3M
recovered
Payment errors aren't random — they're systematic
$1.9M left on the table with sampling
How It Works
From Contracts to Verified Claims
We translate your contracts into executable logic, then run every historical claim through it. No sampling. No guesswork.
Your Contracts
PDFs, fee schedules, amendments
Executable Logic
Every clause becomes code
Every Claim
100% coverage, not 5%
Recoveries Found
With full documentation
No system replacement required — we work alongside your existing stack
What We Find
Where the Money Is
Every audit surfaces a mix of issues. Here's a typical breakdown from a single contract review.
From one contract audit
What You Get
One Finding. Complete Chain of Proof.
Every discrepancy we surface is fully documented — from contract clause to affected claims to exact dollar amount.
§4.2.1
"Modifier -59: 50% of base"
847 claims
CLM-4821, CLM-4935...
Paid 100% instead of 50%
$2.5M paid → $1.2M owed
$1,247,832
Ready to dispute
Every finding is export-ready with full claim-level detail
Every dollar is defensible. No estimates. No extrapolation.
When to Use
The Right Moment for an Audit
Most teams start with a historical review at a natural inflection point.
Contract Renewal
Know your leverage before you negotiate
Dispute Preparation
Build a claim-by-claim case with proof
Vendor Validation
Verify administrators pay by your rules
What Comes Next
Start narrow, expand if value is demonstrated
No system replacement required