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 can assist in developing required compliance plans and creating in-house management and employee training programs utilizing AMG-SIU’s sample documents and the health plan’s current policies. AMG-SIU will initiate its “Train the Trainer” program within the organization to provide the health plan with total control over programs and costs.

Ensure proper provider billing through education. The provider fraud, waste and abuse education program should encompass:

• Proactive material and communication
• Retrospective provider communications
• Reports of provider compliance actions

The Education and Training Program ensures appropriate claims payment through proactive and retroactive employee, provider, and member education. Success is measured by continual reduction in the claims payment error rate. Inherent to that success is a comprehensive effort to educate the providers on coverage and coding principles so as to ensure correct billing practices.