We'll Help You Overcome Your Most Difficult Challenges

As health insurance industry professionals, we understand the challenges you face:

  • Expanding government scrutiny regarding proper claims adjudication.
  • An aging customer base that requires more care and more efficient coordination with Medicare.
  • Intensifying need for internal controls that meet the standards of Sarbanes-Oxley.
  • Shrinking budgets for internal quality control.
  • Increasing pressure from your customers to lower administrative costs.
  • Skyrocketing costs of services from medical providers.
  • Improving the auto-adjudication rate of your organization’s claims.


A relationship with Chapman Kelly will provide you with:

  • Expertise - We utilize error detection models built from years of experience auditing every national carrier.
  • Knowledge - Each one of your organization’s claims can be checked against Medicare enrollment databases to ensure that you are paying in the correct order of primacy.
  • Experience - Our audit professionals average more than 15 years auditing claims.
  • High-tech Advantages – We audit claims with a purpose-built, state of-the-art software platform that has analyzed over $10 billion worth of claims data.
  • Peace of Mind – You’ll know your organization has an industry leading firm on its side.

Why Chapman Kelly?

Knowledge

  • We’ve helped hundreds of companies maximize value and minimize loss associated with health insurance and count over 35 Fortune 500 companies among our clients.
  • Our staff has experience identifying the most complex situations that cause payment errors.

Technology

  • We utilize the research and information capabilities of our advanced software environment - proprietary technology that we tailor to meet your technical environment, standard operating procedures and plan provisions.
  • Our internally developed MAX™ software platform is continually improved upon by leveraging the expertise of our audit professionals and the technical talent of our software engineers.

Results

“Chapman Kelly has an outstanding team behind their sales efforts. Promises made during the proposal and decision making process were kept, and our expectations were exceeded. Thank you Chapman Kelly, your follow-through is second to none!”

-Salomon Mizrahi, First Horizon National Corporation

Our Managed Care Solutions:

  • Claim Audits –Comprehensive or Targeted
    • Medical
    • Dental
    • Pharmacy
  • Provider Bill Reviews