Real-World Results

The problem

Most audits slow down before they even start. Teams spend days pulling files, building spreadsheets, reconciling totals, and drafting reports after the review. During the audit, reviewers repeat the same manual steps in every file, and findings often get written up later, which creates rework and inconsistency.

What we built

A guided audit portal that runs the audit the same way every time, from file selection through scoring and reporting. Reviewers capture findings in the moment, the tool keeps scoring and status tracking consistent, and the executive report is generated from the work already completed, instead of being rebuilt after the fact.

Why it matters

It removes the manual “compile, format, rewrite” cycle that drags audits out and makes results harder to compare across teams, adjusters, and time periods.

Impact

• 70% reduction in pre and post audit work by automating compilation and report preparation.
• 15% reduction in live audit time by reducing manual steps and enforcing a defined review workflow.

The problem

Traditional TPA oversight is often periodic and sample-based. That creates two issues. First, risk can build between audit cycles. Second, sampling can miss the files that matter most, so audit effort gets spent validating routine handling instead of finding emerging severity, reserve drift, stalled litigation, or missed steps.

What we built

A claims surveillance tool that continuously scores claims and highlights the files that deserve attention. It gives managers a repeatable way to monitor claim populations, isolate higher-risk patterns, and target review time to the right claims, instead of expanding audit volume.

Why it matters

Surveillance shifts oversight from “audit everything to find something” to “monitor everything, audit what matters.” That lowers audit load while improving what gets caught early.

Impact

• Surfaces 25% more cases to monitor that were not previously flagged.