Plan Compliance

The only Double-Check Audit Engine™ in the industry.

The specific components of your plan are programmed separately into two different audit engines to identify and catch all potential issues. Each audit reviews every single claim for compliance issues, and then the engine checks the results against each other.

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If there is an inconsistency, it is reviewed by a team of experts who know every detail of your plan. They interpret the results, resolve any provider errors, and regularly update the software’s auditing rules if any plan errors (such as co-pay amounts) are found.

This ensures that every deductible and co-pay is properly paid, and that you are not paying for non-covered items

Our FWA&E audit engine closely examines every single medical claim in real time. Retrospective, randomized audits catch only a percentage of issues, which can translate into inaccuracies, questionable billing, or over-billing. Real time auditing avoids the wasteful practice of tracking down providers after the fact (called ‘pay and chase’), and it helps you avoid delays in claims reimbursements to employees.

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CALL-OUT : Ask any TPA you are considering if they audit for all second and third diagnosis codes.

Who Is Reviewing Your Claims?

LEA’s audit experts are dedicated to claims review. They are intimately acquainted with the specific aspects of your plan and have a deep knowledge of medical practices and pharmacology.