Why Audit?

  • One of the largest studies of third-party claim payment accuracy found the error rate to be over 10%1.
  • Dependent eligibility audits “often find that between 5% and 12% of employees had an ineligible dependent on a company health plan”2.
  • Nearly 80% of hospital bills contain errors3.
  • Auditing helps you meet your fiduciary obligation under ERISA, and it provides a valuable control that will aid in Sarbanes-Oxley compliance.

Why Choose Chapman Kelly?

Knowledge

  • We’ve helped hundreds of companies maximize value and minimize loss associated with health insurance and count over 25 Fortune 500 companies among our clients.
  • Our staff has experience identifying the most complex situations that cause your plan to run at a less than optimal level.

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 has analyzed over $10 billion of claims data from every national carrier and processed hundreds of thousands of employee verification documents.

Results

“This was my company’s first audit and I was very impressed with the way the project was handled in a timely and efficient manner. I would definitely use Chapman Kelly again and recommend them to other companies.”

-Roger Deverman, Avis Budget Group

Our Services

Claim Audits –Comprehensive or Targeted

  • Medical
  • Dental
  • Pharmacy

Dependent Eligibility Audits

1. Centers for Medicare and Medicaid Services, Improper Medicare Fee-For-Service Payments Report, (Baltimore, MD: November 2005)

2. The Wall Street Journal, To stem Abuses, Employers Audit Workers’ Health Claims, (New York, NY: March 2004)

3. Money Magazine, Money Helps, (New York, NY: October 2004)