| $22.38 per employee per month That’s the average savings MedBen clients realized in 2025 through forensic claims review — the largest annual per-employee impact since the service launched in 2007. |
Savings like these don’t happen by accident — or by auto-adjudication. While many administrative carriers and TPAs emphasize speed, MedBen takes a more intentional approach: paying the right amount for the right care. Forensic claims review is central to that philosophy.
MedBen claims processing starts and ends like traditional administration, applying plan provisions and PPO discounts as expected. The advantage comes in between, when we take additional steps other administrators don’t — or can’t, due to PPO contract agreements.
- Our standard adjudication process performs a code review to find upcoded and unbundled claims;
- Expert examiners and advanced surveillance software identify claims requiring further review; and
- Board-certified physicians analyze targeted claims to ensure accuracy, appropriateness, and proper pricing.
This physician-directed approach allows MedBen to go beyond surface-level discounts. Forensic claims review generated an average savings of 35% per targeted claim in 2025, on top of PPO discounts.
The impact is clear: more accountable plan spending with no disruption to member care. To see examples of how MedBen’s forensic claims review works for your plan and your bottom line, contact your broker or MedBen Marketing.