Expertise

Managed Healthcare Unlimited (MHU) collaborates with national and state regulatory agencies on a broad range of issues from routine audits of health plans, including claims reviews, to focused investigations on healthcare violations and abuses to program development and implementation. MHU further contributes to the audit process by developing and writing documents and tools that facilitate and inform the review process. For California-based audits, MHU designed the audit process itself, using a model developed by CMS, and developed technical guides; audit protocols; and operational tools, including a health plan pre-audit questionnaire, audit worksheets, and report templates. MHU has specific experience developing and implementing new managed care and regulatory enforcement programs to meet the challenges presented by federal and state legislation and mandates.

Expertise

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