DSI evaluates 100% of healthcare claims audits. Every claim, every dollar, and every member.
Our root-cause methodology combines human expertise with advanced analytics to help employers reduce costs, streamline operations, and build more reliable client relationships.
“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
Powered by the Healthcare Horizons proprietary root-cause methodology, we bring an unmatched level of accuracy to healthcare claims auditing. DSI's in-depth audits uncover errors, fix root causes, and deliver measurable results, improving financial performance, streamlining operations, and strengthening client relationships. We offer flexible pricing options to meet your needs and accommodate any TPA requirements.
We focus on every healthcare claim, and every possible dollar, to bring employers an unparalleled return on investment.
DSI and Healthcare Horizons bring over 30 years of healthcare claims auditing experience with some of the world's largest employers.
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.
Our carefully selected claims audit team is responsible for over $10B in claims annually for all national payers. No project is too big for our team.
With a thorough 100% healthcare claim audit methodology, our audit team recovers millions of dollars for clients each year.
With DSI's team of claims audit experts, we take control of your company's most significant expenses and put real dollars back where they belong.
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.
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 our claims audit findings.
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.
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.
The average return ranges from 1 to 3 percent of total medical spending. There are, however, claims audits with much higher returns. In addition to the immediate ROI, we often facilitate a root-cause correction for future cost savings.
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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