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ACS, Inc. |
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5830 South 142nd Street |
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Suite B |
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Omaha, NE 68137 |
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Do you need to audit a Rx claims administrator to ensure that claims are being paid as defined in the plan document? If so, then ACS can perform a vendor audit for you. Our past audits have uncovered many cases in which the administrator overpaid claims for reasons including miscalculated network discounts, incorrect coordination of benefits, and improper patient cost sharing. Once the audit is complete, ACS can help you and the vendor implement any necessary changes to the claim administration process.
Also, if a vendor has promised to achieve certain performance benchmarks, such as a reduction in trend, then ACS can perform a Performance Validation Audit (PVA) for you. A PVA will show if your actual benefit plan experience reflects the performance promised by the vendor. Our clients have found it valuable to have an objective, independent third party like ACS perform these kinds of audits, particularly in cases where financial incentives are linked to performance. |
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