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Healthcare Audit and Compliance Solutions

Waste, fraud and abuse can drain money from your programs in many ways, from incorrect billing to data theft. This affects not only you, but also the members paying premiums, the legislators setting your budget – and the taxpayers funding your programs. Our Healthcare Audit and Compliance Solutions can help.

Prevent losses and recover funds with our combination of proprietary automated tools, onsite procedures and team of industry experts. Our web-based healthcare audit and compliance system delivers the highest degree of automation, transparency and reporting. And we work professionally to preserve your provider relationships. That’s why our clients trust us to conduct 25,000 healthcare audits annually – more than any other company.

Our customizable healthcare audit solutions cover a wide range of health program needs:

  • Retail, specialty and mail order pharmacy audits
  • Claims overpayment audit and recovery
  • HIT, DME and Home Health audits
  • Fraud analytics and detection
  • HIPAA compliance testing

With more than 20 years of pharmacy auditing and prescription benefits consulting experience, our expertise covers the continuum of healthcare. We make the process faster and more efficient for several healthcare audit types:

  • Onsite and Desk audits for retail pharmacy
  • Scalable, concurrent claims audit and recovery
  • Specialty and Mail Order Pharmacy audits
  • Home Infusion Therapy provider onsite audits
  • Durable Medical Equipment provider onsite audits
  • Home Health provider onsite audits
  • Fraud Investigations and SIU support

With Xerox, you can ensure everyone in your healthcare program supports one goal: giving patients the care and access they need – responsibly.

Audit and Compliance Resources

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Wyoming Medicaid Case Study

Wyoming Medicaid

The integration of health information enabled more effective treatment of Medicaid members and improved population health.

See Wyoming Medicaid case study 

HealthFocus Newsletter

Industry news and information to encourage conversation and broaden perspectives.

Read Winter 2015 issue 

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