Healthcare Claims Audits

A comprehensive approach unlike any other

DSI focuses on auditing 100% of claims to ensure maximum ROI and the highest level of accuracy.

Click the button to request a proposal and learn more about what we can do for your benefits waste reduction and risk mitigation strategy.

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Medical Claims Audit Hero | DSI

Random sampling misses over 90 percent of the errors caught by the methodology based on the 100-percent-of-claims analysis.”

- Professor Ronald Klimberg, Decision and System Sciences Department of the Haub School of Business, Saint Josephʼs University

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Powered by a proprietary set of algorithms that enables a 100% audit, we bring an unmatched level of accuracy rather than taking a random sampling of your medical claims.
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DSI's team and partners do most of the work, keeping you in the loop the entire time. We take that closer look, so you don't need to.
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We monitor the recovery efforts of overpaid claims by your third-party administrator until you are fully satisfied by the results.
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We offer flexible pricing options to meet your needs and accommodate your TPA requirements. All to recover more dollars for your bottom line.
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See the DSI Difference

We focus on every claim, and every possible dollar, all to bring you an unparalleled return on investment:

Experienced Auditors

DSI and our partners have over 30 years of auditing experience with some of the world's largest employers.

A Trusted Leader

DSI is an HR leader built on core principles designed to save clients millions in spending and limit their risk while remaining sensitive to their employees' needs.

Large Corporations Welcome

Our carefully selected audit team is responsible for over $10B in claims annually for all national payers. No project is too big for our team.

Catch It All

With a thorough 100% audit methodology, our audit team recovers millions of dollars for clients each year. Imagine what we could save your company.

Don't allow systemic errors to cost you millions and short-change your employees.

With DSI's team of audit experts, we take control of your company's most significant expenses and put real dollars back where they belong.

What is the cost of Claims Audit services through DSI?

We offer a risk-free pricing structure. We base fees on a percentage of dollars recovered – not just errors identified. We also offer fixed-fee or custom pricing options to accommodate your needs.

What is the expected time commitment from a client?

We work behind the scenes so you can focus on your business. You provide the basics, such as TPA information, plan documents, and funding amounts. After that, you only need to review the report of audit findings.

Will the Claims Audit process adversely impact members?

We test areas such as benefit maximums and exclusions that could impact members if initiating a recovery. We alert clients so they can make recovery decisions. We do not bill any contingency fees for overpayments that employers do not wish to pursue.

Will a Claims Audit harm our relationship with our TPA?

All national third-party administrators expect periodic audits as employers fulfill their fiduciary responsibilities. We have excellent working relationships with external audit coordinators across the country. Our goal is to facilitate the best possible relationship with your TPA.

What kind of return can I expect to receive with a Claims Audit?

The average return ranges from 1 to 3 percent of total medical spending. There are, however, projects with much higher returns. In addition to the immediate ROI, we often facilitate a root-cause correction for future cost savings.

Will employee protected health information (PHI) remain secure?

Data integrity and security are top priorities for DSI; like our other services, we maintain extensive administrative, technical, and physical safeguards to protect the confidentiality, integrity, and accessibility of PHI consistent with the requirements of HIPAA Policies.

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