We offer a broad set of audit categories that target your improper payments, high error areas, and other abuse, including:

  • Inpatient and Facility Audits – including Diagnosis Related Group (DRG), Hospital Bill Audit, Ambulatory Payment Classification, and Skilled Nursing Facility
  • Outpatient and Ancillary Audits – including Durable Medical Equipment (DME), Home Health and Hospice, Home Infusion, and Pharmacy
  • High Risk and Other Specialty Areas – including specialized Medicare and Medicaid Audits, Contract Reviews, ICD-9/ICD-10, and more

We have a nationwide footprint, providing audit services to some of the industry’s largest health plans, and are responsible for the audit of DMEPOS, Home Health and Hospice claims across the country as the CMS Recovery Audit Contractor for Region 5.

All of our audit services are further enhanced by an industry-leading data processing platform, Performant Insightâ„¢. This proprietary product optimizes the scoring and selection of claims for audit and provides on-demand, online reporting of data that matters to you.

Our inventory of audit categories and specific review topics is constantly evolving.

Talk to us to learn more about our latest offerings.

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