Our auditors follow a specific, proprietary methodology for re-adjudicating claims. Auditors review all claim actions from eligibility checking to finalization of the claim. Services include:

• Audit and Recovery: Trained associates conduct a quality review of claims processes and operations, identify key overpayment trends, and support recovery efforts.


• Audit Outsourcing: Our service center audit staff will absorb all or part of your health plan's audit function.


• Auditor Support: Audit professionals provided by Paramount can supplement your health plan's in-house processes or special projects on a temporary basis.

With Claims Audit Services from Paramount, your organization can benefit by:

• Greater insight into your organization's claims administration
• Cost controls from properly adjudicated claims
• Identification of overpayment trends and support for recovery efforts
• Higher quality of claims processing than may be possible within the organization
• Workflow development & Manual intervention tracking

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