Auditing, Compliance, and Contract Services

auditing

Services include support in the areas of medical and pharmacy claims auditing, pharmacy purchase, inventory, and billing reconciliation audits, developing internal audit procedures and quality assurance measures, and third party claims auditing and compliance reviews.

  • Third party and PBM administration medical and pharmacy claims auditing for duplicative and/or incorrect payments
  • Pharmacy claims rebate auditing and dispute resolution
  • Pharmacy purchase, inventory, and billing reconciliation audits
  • Development of internal audit procedures and quality assurance measures
  • Third party health care claims reimbursement policy compliance review
  • Drafting and review of health care and pharmacy service agent contract proposals
  • Funding procurement and drafting support for public and private grants