healthcare fraud recovery
the consulting authority
how much of your stolen money can we recover for you?
in 2022 employers burned $1,200,000,000 in healthcare overcharging - this is fraud
Attention: Self-Insured Employers
Providers are overcharging - We assess and re-adjudicate 100% of paid claims over the past 36 months. We recover this overcharging for the employer and employees.
The plan sponsor’s auditing should be performed by an unrelated third party - not your administrator, network, insurance co., claim adjudication vendor, or broker. These are potential benefactors of how overcharging occurs.
This offer involves no financial risk, no disruption, and no plan changes = No Brainer
All Employers have been bamboozled by Hospitals, PBMs, and Insurance Companies - Stop funding excessive provider profits.
Advanced Benefit Design Institute’s Claims Review & Recovery Program is the solution
performance guarantees:
Our work is guaranteed to reduce your Healthcare Spending.
We deliver 100% transparency and perform to a Fiduciary Standard.
You can retain your Broker.
Our fees are 100% Contingency Based.
Plan Fiduciaries fulfill Federal ERISA and CAA oversight requirements.
Advanced Benefit Design Institute will eliminate overcharging for any self-insured employer, guaranteed.
sample finding:
The employer’s TPA told the client that their agreement included periodic claim reviews to ensure that claims were properly priced and paid.
Our method discovered that the TPA’s “claim reviews” and price negotiations were causing overpayments and egregious price gouging that cost the plans and members millions of dollars.
• A hernia repair usually costs $1,300 in total. This client paid $57,159.
• $29,419 of that went to their TPA for “negotiating a good rate”.
• Our method discovered, reported, and recovered 100% of the TPA markup.
• The client will never pay that much again.