Crown gives third-party administrators outsourced claim review, FWA monitoring and investigations, market rate benchmarks, client-ready reporting and audit preparation, all from one independent partner.
Talk to us See the servicesClients are auditing their administrators more often and asking for independent numbers. Building that capacity in-house is slow and expensive.
Claim volume spikes don't wait for a new hire.
RBP and high-dollar claims need a defensible market reference.
An outside auditor shouldn't find problems before you do.
Use one service or combine them.
Coding and claim review, pre- or post-payment, when your team needs extra hands.
Market rates from published payer data to support RBP pricing, network decisions and high-dollar bills.
Independent, client-ready analytics you can hand to the plans you administer.
Find and fix issues before an outside auditor does.
Outlier detection on provider billing, with case files your team can act on.
We learn your claim mix, systems and priorities.
BAA and data transfer set up to your standards.
We work the queue or run the analysis.
Clear write-ups for your team or your clients.
Crown pairs statistical and healthcare-economics expertise with published payer rate data to give TPAs numbers they can defend.
Scale review up or down without hiring.
Market references built from published payer rates.
Independent reporting that strengthens your renewals.
Independent support for claims, pricing and payment-integrity teams.
Tell us where your team is stretched and we'll scope around it.
Talk to usCrown brings together healthcare economists, insurance specialists and benefits consultants, and PhD statisticians and data scientists, working alongside experienced medical coders. The people who build the data pipeline also review the results, so every finding is checked by someone who understands both the numbers and the claim.
Experts in how payers price care and where the money leaks.
Plan design, payer contracts, benefits strategy and actuarial context.
PhD-level methods and pipelines that turn billions of published rates into answers.
Experienced coders reviewing CPT, HCPCS and ICD-10 against coding rules.
Tell us what you'd like help with. We'll follow up to scope a pilot.
Or email: info@crownadvisory.com