IR&AS employs a very straightforward approach to auditing. The audit process is initiated with a complete understanding of exactly what you, our client, are looking for as an end product.
- IR&AS can perform an Operational Audit designed to assess a Third Party Administrator’s or Managing General Underwriter’s ability to fulfill the service, fiduciary, reporting and management requirements of your company.
- A Premium Accounting Audit can be conducted to verify the accuracy of premium rates, commissions, and administrative fees. Premium remittances, fee allocations, and the report development thereof, are tested for exactness. Delinquency and collection processes are examined to corroborate that adequate measures are taken to collect the required premium when due.
- Claim Audits are conducted either on-site or in our office. A detailed, thorough review is completed for each claim. Claims are reviewed for adherence to the issued contract. We ensure that individual claimants meet eligibility requirements, that benefits paid are valid, and that claims are properly adjudicated.
- Underwriting Audits are performed by experienced underwriters in order to assess compliance with underwriting and pricing guidelines and procedures. Our audits include evaluation of risk assessment and selection. Underwriting files are also reviewed to ensure that underwriting decisions are properly documented in the file.
- On-site audits of MGUs and TPAs, on behalf of issuing carriers and reinsurers, can be performed to assess the ability to successfully fulfill the requirements of the MGU/TPA Agreement, or to ensure that an Insurance Company’s policies and procedures are administered in accordance with Reinsurance Agreements.
- Hospital Bill Audits and/or negotiations can be conducted on your behalf.