CRS provides comprehensive TPA claims auditing services, both onsite and as desk audits.  We conduct aggregate claims audits, specific claims audits, and statistical sample audits. We review sample claims for eligibility, application of plan and contractual provisions, proper investigation, procedural and financial accuracy, statutory compliance, and turnaround time. 

We also review the administrator's staffing, policies and procedures, customer service standards, and other efficiency measurements. 

Premium and Billing Auditing

CRS conducts thorough audits of TPA billing and premium accounting results to make sure customer billing is proper and premium collection is compliant.  Audits include review of staffing, policies and procedures, customer service standards, and other efficiency measurements.

Policy Administration Auditing

Policy administration audits include review of policy process issues such as certificate issuance, identification cards, agency and administrator licensing, client and case administration, and other compliance issues.

Contact CRS today for more information about our TPA auditing services.