TareThe offer is one group and three months of bills. That's the fourth step, though — not the first one. No member data moves until there's a signed BAA and a secure channel, which means the thing you actually do first is have a short conversation.
Here is the entire sequence. There are four steps, you don't prepare anything for the first one, and you can stop after any of them.
A 20-minute scoping call
How many groups, which carriers, how the bills arrive today, and what your systems can export. We'll tell you on that call whether we can read your data and what the first cycle would cover.
BAA executed
Your business associate agreement form or ours — we'll sign yours, and we don't make that a negotiation. This happens before the first byte moves, without exception.
A secure channel is opened
A write-only upload link, SFTP credentials, or a scoped cloud container — whichever level of interface suits your team. Want to test the pipe first? We'll run it end to end on a synthetic file.
One group, three months of bills
You send the bills, the matching enrollment extract, and whatever you have for rates and billing rules. You get back an audit report and an exception workbook — and a call where we walk through every finding.
Why three months, and why one group
Three months because the findings that are worth money only prove out across consecutive bills. A termination that was never applied looks like a normal line on any single bill; it's the repetition that exposes it. Three months is also the retro window most carrier contracts allow, so it's the range where the errors we find are still recoverable.
One group because it's the smallest thing that produces a real answer. You're not buying an implementation — you're finding out whether there's money in your bills. If the first cycle comes back clean, that's a legitimate outcome and worth knowing.
What we need from you to start
A conversation. That's the whole list.
You don't need to pull files, standardize a format, get IT involved, or know your proration rules off the top of your head before we talk. Those are things the audit sorts out — several of them are things the audit tells you.
What to say in the first message
If you'd rather skip the call and start in writing, this is all we need to give you a useful answer:
- Your organization, and roughly how many groups you administer or broker
- Your main carriers — three or four is enough to tell us what we're dealing with
- How bills arrive today: portal download, EDI, emailed spreadsheet, PDF, paper
- What's prompting the question — a specific dispute, a renewal, or general suspicion that the bills aren't right
You'll get a straight answer back, including "this isn't a fit" if it isn't.
What this costs
The audit is priced per group, delivered monthly, and cancelable any month. There's no implementation fee, because there's no implementation — format mapping is our first-cycle cost, not a line item on your invoice. Pricing for your specific situation comes out of the scoping call, once we know the carrier count and how the bills arrive.
Where it goes from there
An engagement can stay exactly what it is — an audit, delivered monthly — and simply cover more as you go. Add groups and carriers at whatever pace suits you; the work scales without changing shape, and it costs you nothing to leave it where it is.
Two other conversations tend to come up, usually around the third or fourth cycle, once you've seen what the recomputation actually catches. The first is what happens when the sending stops — your formats are already mapped by then, and the exceptions can reach you without anyone assembling anything. The second is the harder question underneath all of this: whether the bill you're checking is the one that should have been produced in the first place.
We don't lead with either, and neither is a condition of the audit. But if you'd rather know now than in four months, raise it on the scoping call and we'll tell you where that goes.