What We Do


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) .

Pre-payment Claims Editor (Prospective Claims Review)
Retrospective Claims Review
Data Analysis
Program Options: Pick and choose services
Web-Based Reporting
Secure Online Access
On-line Investigation Interface
Training Program and Compliance Plans
Implementation
History Analysis
Preliminary Investigations
Extensive Investigations
Provider and Member Monitoring
Recovery Programs
Provider and Member Monitoring
 


Upon completion of a preliminary or extensive investigation, the health plan may elect to educate the provider or the member on impropriety or questionable activity. AMG-SIU will monitor the provider or member for the designated time period to determine if corrective actions have been taken by the provider or member and report the findings to the health plan.