HMS helps make the healthcare system work better for everyone.

We help government and private healthcare programs and sponsors contain costs and improve accuracy.

HMS makes sure that healthcare claims are paid accurately and by the responsible party.

  • 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 beween 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.

HMS Blog

 

Medicaid RAC