Medical Review
We validate that beneficiaries receive medically necessary and correctly coded services that are appropriately reimbursed to legitimate providers. We have experience identifying deviant billing patterns such as overutilization, unnecessary services, and upcoding that facilitate substantial savings to our customers. Through our reviews, we identify gaps in policies and program vulnerabilities at risk for waste and abuse. By identifying and mitigating these risks, CSA has prevented the loss of millions of dollars from healthcare programs.