Your TPA audits whether claims were processed correctly. Nobody audits whether the contracted rate itself is competitive — because the TPA negotiated the price. We use transparency data they structurally cannot.
Your TPA's job is claims accuracy — did the claim match the contract terms? But they can never answer the harder question: are those contract terms any good? They negotiated the rates. They're conflicted.
Is the negotiated rate competitive vs. peer plans, Medicare, and in-network alternatives? This is renewal-cycle ammunition — not claim-cycle work.
Find pricing errors in already-paid claims and generate appeal packages. Real dollars back to the plan. Contingency pricing = psychologically free.
The Rate Competitiveness Scorecard is the artifact an ERISA attorney attaches to the fiduciary file. Documented evidence of prudent oversight.
Request a free Rate Competitiveness Scorecard for your plan. One page, one headline number, dollarized findings.
Request Your Free Contract Audit