Audit 

Claims: each claim that enters the system is required to pass through over 100 checks and edits prior to coverage being approved or rejected. Random audits both electronic and manual are preformed by our claims adjudicator to further protect the members and plan sponsors.

Verification of compound claims, "No Substitution" claims, reimbursement claims, pharmacy statistical analysis, on-site pharmacy audits and member validation of receipt of medications are all part of an ongoing program of random and routine checks and balances to ensure the highest standard of performance is maintained for your plan.

Trending

Group Benefits Unlimited provides your team with a year over year audit of benefit utilization and cost. This audit provides you with the tools to accurately assess claim costs per benefit line over a period of time. Trending utilization is a vital tool in cost containment. Timely analysis allows for implementation of solutions before benefits are negatively impacted.