Lumelight’s Medical and Prescription Drug Claims Audits uncover errors, identify opportunities for recoveries, and ensure plans perform as intended – across every claim, carrier, and partner.
Audits span eligibility, coding, pricing and payment to give a full view of plan performance and partner compliance.
Experienced auditors and clinicians work together to identify discrepancies, recover overpayments and strengthen processes.
Findings are addressed directly with carriers, PBMs and TPAs through open communication that preserves relationships and drives results.
Each audit delivers prioritized findings and recommendations that help teams implement change with confidence.
Trend analysis and benchmarking uncover patterns over time, helping organizations refine plan design and maintain long-term accuracy.
Lumelight’s structured process and independent review provide the assurance employers need to trust every claim, every partner, every time.
See how employers have strengthened plan performance and recovered overpayments through Lumelight’s Medical and Prescription Drug Claims Audits. Each story shows how actionable insight builds accountability and trust across every partner relationship.
Lumelight experts share best practices on medical and pharmacy claims auditing, data reconciliation and performance management, helping organizations strengthen oversight while maintaining strong carrier relationships.
Explore resources that show how Lumelight turns complex claims data into measurable improvement and peace of mind.
Lumelight helps employers maintain the accuracy and integrity of their health plans so every claim reflects the care, cost and confidence employees deserve.
We handle the complexities of benefits compliance and administration, empowering you to focus on what you do best.
