TFG Partners, LLC

Large employers with self-funded medical plans often receive promises of efficiency and savings from claim administrators when negotiating service agreements. However, the reality may not always agree. To truly assess whether these commitments are being met, running medical claim and pharmacy benefit manager audits can deliver insight. Comprehensive audits that review 100% of claim payments—as well as all charges billed by your TPA and PBM—can uncover variances and ensure accountability. Given the substantial sums involved in medical claims, even slight errors can result in significant, unnoticed losses.