CSA specializes in performing healthcare audits, data analytics, medical reviews, investigations, and benefit recoveries. Our corporate experience reaches back to the inception of the Medicare program and our understanding of complicated government programs and payment models has significantly contributed to our success in protecting the financial integrity of America’s healthcare system.
Who — We are an independently managed company whose core values are:
- Insight – Quality analysis, auditing, and reporting always lead to better outcomes. And in the ever-evolving world of healthcare, it’s more important than ever that we do more than simply find what’s wrong. We use our vast experience and understanding to create better, more actionable intelligence for our customers.
- Protection – Through the identification and application of that knowledge, we help protect and ensure the financial integrity of America’s healthcare. Our purpose is to safeguard against errors, discrepancies, waste, fraud, and abuse.
- Innovation – We will continue to stay ahead of the curve on necessary technological solutions that will allow us to maximize the data and provide efficiency for every component of the government healthcare matrix we serve.
What — We specialize in healthcare compliance audits and data analytics incorporating clinical reviews and knowledge of regulatory policies and payment models.
Where — We have offices located in Alabama, Iowa, and North Carolina. We are headquartered in Birmingham, Alabama.
When — We were formed in 2002 following our task order award as a Program Safeguard Contractor. As stated above, our corporate experience reaches back to the inception of the Medicare program, and our associates’ years of experience in understanding government programs has significantly contributed to our success.
Why — We are a pioneer in using data analytics to understand complex healthcare data. Our statistical models have been instrumental in identifying high-dollar areas of risk. Our approach has saved and protected over $1 billion for our customers. Our audit scope is based on data analytic model results. This allows our auditors to spend time focusing on the issues, which create results.
CSA was created in 2002 to administer the provisions of any task orders under the Centers for Medicare and Medicaid Services’ (CMS) Program Safeguard Contract (PSC). However, our organization’s experience reaches back over 50 years as a government healthcare contractor.
In 1996, Congress enacted the Medicare Integrity Program to give CMS the authority to contract with other than, but not excluding, Medicare Carriers and Fiscal Intermediaries to perform certain PSC functions. This strategy for the detection and prevention of fraud and abuse involves separating program safeguard functions from claims processing activities. CSA was one of 12 PSCs awarded a contract to perform this work.
Working with the extensive reach of the Medicare program, we have gained valuable experience working with multiple terabytes of healthcare data from all 50 states and years of accumulated healthcare information. Very few organizations today have access to such a rich and comprehensive body of knowledge, resources, and experience as that available to our organization.
CMS, the U.S. Department of Veterans Affairs (VA) and TRICARE Military Health Services have recognized our healthcare analytical approaches with the award of several additional contracts.
In 2017 and 2018, our data analytics capabilities were highlighted and presented at the SAS Global Forum by industry leaders in our field.