• Fraud, Waste
    and Abuse

    To help payors combat Medicaid fraud, waste and abuse, HMS offers a comprehensive solution that includes forensic editing, predictive modeling, and investigations services.

  • Coordination
    of Benefits

    HMS’s proven data mining techniques help locate valid other coverage for plan beneficiaries to assist payors in accurately coordinating payments and pursuing recoveries where claims were paid inappropriately.

  • Dependent
    Eligibility Audits

    Most employers find that between 4% to 8% of dependents on their health plan are ineligible for coverage. HMS can identify and help you permanently remove ineligible dependents from your plan to make an immediate and substantial financial impact.