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In-Depth Claim Audits to Reveal the Insight You Need
Specialized knowledge in health claim adjudication gives you peace of mind that the obligations of multiple parties are being honored and opportunities for cost management are being realized in your health plan. Our highly skilled and seasoned professionals take a consultative approach that recognizes the interests of all parties while delivering measurable results.
We regularly collaborate with self-funded employers, administrators, stop-loss carriers, managing general underwriters, reinsurers, and insurance brokers to help settle health claim liabilities, supported by relevant facts and thorough review.
Our goal is to reach fair resolutions through a consultative process that respects every party’s interests while helping save millions of dollars cumulatively. We build lasting relationships with our customers and deliver meaningful insights that drive transformative change.
Our extensive range of healthcare claim auditing services includes:
Plan Sponsor Audit Services
- Targeted claim audits
- Randomized claim audits
- Operational reviews
- Pharmacy Benefit audits
Stop-Loss Claim Review Services
- Specific Stop-Loss claims
- Aggregate Stop-Loss claims
- HMO Re claims
- Provider Excess claims
- Carrier claim audits
- Reinsurer claim audits
- Claim overflow management services
- MGU audits
- Administrator audits
Additional Consulting and Review Support
- Plan Document review
- Stop-Loss Policy review
- General claim consulting
- Complex claim reviews
- Claim staff training
Additional Resources
Market Trends
Our 2026 report unites Brown & Brown and Risk Strategies resources, knowledge and proven experience to deliver stronger insurance solutions for commercial insurance, employee benefits and personal insurance.
Shaping Transparency in Today’s and Tomorrow’s Pharmacy Benefits Marketplace
True transparency in the pharmacy benefit marketplace is more than publishing numbers or simplifying reports. It requires clear contractual, financial, and clinical accountability so plan sponsors can understand what drives their costs and what ...
The Cost of Ignoring Sleep: Improving Benefits Strategies for Better Outcomes
As is often said: sleep isn’t a luxury. It is a physiological necessity.
Transforming Specialty Pharmacy: A Holistic Approach to Better Outcomes
Specialty pharmacy is undergoing transformative changes, driven by the recognition of the need for a holistic approach to patient care, complexities of new treatments, advancing technologies, and evolving healthcare policies. Amidst these ...
Connect with Brown & Brown
Brown & Brown delivers specialized healthcare claim audit services that help organizations make informed decisions and optimize plan performance. Our actuarial and analytical professionals provide clarity, accountability, and actionable insights that strengthen financial outcomes. Connect with us to learn how we can support your organization’s goals through precise and data-driven healthcare claim audit strategies.
