At US Beacon, we’re redefining healthcare expense management by delivering measurable savings through expert claim compliance review. Our performance-based approach aligns our success with yours, ensuring every claim is handled with accuracy and integrity.
At US Beacon, we specialize in both pre-payment and post-payment audits, offering flexible solutions tailored to your plan’s unique needs:
Our commitment is simple and transparent:
Our detailed claim analyses (pre-payment or post-payment) include:
Our process is designed to deliver maximum accuracy with minimal disruption. By combining advanced technology with expert oversight, we conduct thorough audits that uncover billing errors, ensure contract compliance, and recover costs—without interrupting your current operations. Every step is built to protect your plan, your people, and your bottom line.
Execute a Business Associate Agreement (BAA) and Statement of Work (SOW) to formalize the relationship and ensure HIPAA compliance.
Establish the scope and criteria for medical bill reviews, including:
Coordinate records retrieval through preferred channels, including:
Complete medical bill reviews within 24–48 hours of receipt.
Deliver a compliant, updated clean claim that reflects all federal, state, and payer-specific billing regulations and guidelines.
We operate at the highest levels of security and compliance, protecting sensitive PHI and ensuring trust across every transaction.
Trusted as the sole medical bill review partner for a national cooperative serving public sector and healthcare clients, a testament to our proven value.
Combining the scalability of artificial intelligence with the critical thinking of certified medical code, physicians, and nurses, we deliver fast, defensible, and accurate outcomes.
Flexible engagement models support your needs, whether you are managing prospective savings or auditing paid claims for recovery opportunities.
Free from investor influence, our decisions are guided solely by what is best for our clients and their patients, ensuring transparency, alignment, and long-term partnership.
We move fast without compromising quality — delivering fully reviewed, clean claims within industry-leading timelines.
Every claim is returned in a payer-ready, regulation-compliant format that aligns with CMS, AMA, NCCI, and state-specific rules, with an appeal rate of less than 1% and to date, never lost an appeal.
Whether you are reviewing all claims, high-dollar thresholds, or targeted service lines, we tailor the review structure to your strategy and pain points.
We work within your infrastructure — offering EDI, SFTP, or custom secure transmission options for seamless record retrieval and integration.
Clients consistently experience reduced claim errors, faster reimbursement cycles, and significant financial recovery through our optimized review process.
