Engagement

How we work

A defined sequence, a fixed scope, and a written record at the end of it. The engagement is designed to withstand review by auditors, boards and counsel.

I

Investigate

We gather the contracts, claims data, compensation disclosures, plan documents and financial records. We request what is required, in writing, and note what is withheld.

  • Document and data request issued to vendors
  • Claims and financial records reconciled to ledgers
  • Contract chain assembled in full
II

Verify

We determine what the numbers mean. Each material payment is tested against the contract in force, the plan document and the evidence available.

  • Payments tested against contractual entitlement
  • Compensation traced to its source
  • Exposures and unsupported amounts quantified
III

Document

Leadership receives a written record: what was found, what it means, what remains unresolved, and what action we recommend. Written to be read by a board.

  • Findings with supporting evidence
  • Fiduciary and contractual exposures
  • Recommended action and sequence

Working principles

Independence

No commissions, referral fees, or vendor compensation. Ever.

Discretion

Engagements are confidential. Findings belong to the client alone.

Direct access

You work with the people doing the work. No layers.

Evidence

Every conclusion is traceable to a document, a contract, or a claim.

Before you approve another U.S. healthcare expenditure, know what you're paying for.