AMG-SIU provides an array of health care claims editing services and fraud and abuse services. These services are offered separately or in combination according to your specific needs (See Program Options). While a few services must be combined, the remaining services are optional and may be provided by your existing staff (or ours) .

AMG-SIU is exceptionally experienced in managing large data downloads from existing claims systems. There are several steps in the implementation process.

AMG-SIU will analyze the health plan’s business processes. AMG-SIU’s operations and IT staff will discuss with the health plan the product types and variations, federal, state, and local coding requirements, data interface, and operational procedures.

The AMG-SIU Automated Claims Evaluator (ACE) allows each health plan’s products to be tailored to its needs. Most other editing systems only provide the federal edits and do not tailor the edits to your Medicare region, state Medicaid and CHIP specific requirements, or the health plan’s commercial product specifics.