Medical Claims
Auditing

Quantas simplifies your path to savings.

We help self-insured employers uncover and recover overpaid healthcare claims, putting money back into your business. We audit any TPA or claims administrator with a detailed, contingency-based approach, ensuring you only pay for results. Let us help you take control of your healthcare spending and maximize savings.

Medical Claims Auditing
why you should audit medical claims

When you choose to self-insure your healthcare expenses, you remove the direct financial incentive for the claims payer to control medical costs. This will lead to overpaid claims resulting in additional expense to your plan. With medical expenses on the rise again, employers cannot afford to continue funding overpaid claims. The best way to resolve this problem is to conduct periodic reviews of your claims data. This allows the employer and claims payer to work together to ensure that claims are paid as accurately as possible and that mistakes that are made are corrected.

our approach is different from most vendors.

SUBMIT AN AUDIT REQUEST

Our approach is different from most vendors in that we do not utilize a sampling methodology. We perform a comprehensive review of all paid claims using our electronic capabilities and proprietary claims audit logic. We are confident that a comprehensive review is superior to a sampling methodology because it:

Identify
Errors

Identifies all incidences of a particular type of payment error

Validate
Findings

Allows for the payer to validate the findings of the audit based on specific claims information

Process
Improvement

Provides more convincing evidence of operational issues at the payer site to facilitate process improvement and prevent future occurrences

A 2% error sounds small until it comes out of every dollar your company spends on your employees’ healthcare

A company with 1,000 employees typically has the opportunity to save more than $250,000 in medical claims costs. This potential can be realized through the identification of a 2% error rate. Typical error rates for Third Party Administrators range from 2% to 5%. A 2% error sounds small until it comes out of every dollar your company spends on your employees’ healthcare.

Audit & Analytics Services
applying professional expertise across the entire data set

Today’s database technologies have rendered sample claims audits obsolete, but many payers have resisted the move toward a more thorough validation of self-insured claims. Quantas is helping America’s leading companies change this market dynamic. With healthcare transactions still lagging behind manufacturing and banking in acceptable error rates, the ability to apply systematic and electronic reviews proves extremely valuable to at-risk entities. Quantas utilizes SQL-based programming to apply the expertise of our professionals across the entire data set of paid claims for employers. This electronic review is not limited by the size of the claims file.

Claims Audit

Performance Audit

RFP Support

TALK TO A PRO

REQUEST A MEDICAL CLAIMS AUDIT

SUBMIT AN AUDIT REQUEST

Maximize Accuracy
& savings

Quantas Advisors delivers a comprehensive Search & Rescue process to uncover and recover healthcare claims errors. Our experts leverage in-depth industry knowledge and advanced data analysis to identify overpayments, resolve inaccuracies, and return real savings to your organization. By balancing flexibility with advocacy, we help you achieve financial clarity while maintaining strong payer relationships.

Search &
rescue

ACCURACY & ERROR REDUCTION

Complex provider contracts and benefit plans often create errors and inefficiencies. We uncover inaccuracies, ensuring claim precision and delivering measurable savings for your business.

THE CHALLENGE

AUDIT SEARCH & RESCUE PROCESS

Our proven approach uses thorough data analysis and plan reviews to identify errors. We resolve discrepancies, recover overpaid claims, and drive financial impact for your organization.

THE SOLUTION

EXPERTISE & SAVINGS IMPACT

Industry experts tackle complex challenges to improve claims accuracy, optimize processes, and deliver substantial savings for employers seeking greater cost control.

THE RESULT

Let us audit your
medical claims.

And handle all the heavy lifting so you can focus on your business.

SUBMIT AN AUDIT REQUEST

Medical Claims
Auditing

Quantas simplifies your path to savings.

Medical Claims Auditing
why you should audit medical claims