Audits, assessments and fraud detection

Audits, assessments and fraud detectionUtilization Reviews

Mega Assistance ensures that hospitalization occurs only when medically necessary and in the most-cost-effective setting. After a beneficiary is admitted, Mega undertakes daily care management procedures.

Medical bill audits

Mega Assistance reviews medical bills or assure accuracy and compliance with customary and usual fees and fee schedules. Mega determines that invoices reflect only the services delivered.

Independent medical evaluations

Mega Assistance, with it’s associates, conducts independent medical reviews after the fact.

Fraud detection

By its rigorous management of medical providers in the local communities, Mega Assistance prevents abuse and fraud in the delivery and cost of services.