Four phases. No open-ended discovery.
Every engagement follows the same method whichever service you start with, so you know what happens next and when. Scope and fee are fixed before work begins.
At a glance
- 01Phases
- 4
- 02Scoping call
- 30 minutes
- 03Fee
- Fixed before start
- 04Findings
- Presented live
Assess, quantify, remediate, sustain
Assess
We review your OPAIS record, policies, TPA reports and a sample of real claims. You receive a written picture of where you actually stand, tested against audit criteria rather than against a generic checklist.
Quantify
Every finding is sized — in dollars where possible, in severity always. Compliance exposure on one side, unrealized savings on the other, so leadership can prioritize on evidence.
Remediate
A prioritized plan with named owners and target dates. We work alongside your team through execution rather than handing over a report and leaving you to interpret it.
Sustain
Monitoring cadence, self-audit calendar and policy version control, so the same finding does not reappear at your next recertification.
One method, whichever service you start with.
The phases do not change based on which service line brought you to us. What changes is where the emphasis sits — a mock audit spends longer in Assess, a recovery engagement spends longer in Remediate.
The first four weeks, week by week
01Before week 1
- What happens
- A 30-minute scoping call, then a written statement of work with fixed scope, deliverables, timeline and fee. Mutual NDA and BAA signed.
- What we need from you
- A named owner on your side, and a signature
02Week 1
- What happens
- Kick-off call, data request issued, engagement plan confirmed with dates. Vendor credentialing started if your system requires it.
- What we need from you
- Acknowledge the data request within 48 hours
03Week 2
- What happens
- Data received and validated. Testing begins. First clarification questions raised.
- What we need from you
- Complete data — this is where engagements most often slip
04Weeks 3–4
- What happens
- Testing continues, with two to three short calls as questions surface. Early significant findings flagged as we go rather than held for the report.
- What we need from you
- Availability for short clarification calls
05Week 5
- What happens
- Draft findings shared in advance, then presented live. Your team challenges and corrects before anything is finalized.
- What we need from you
- Pharmacy, compliance and finance in the room
We escalate at day five if the data request is incomplete. It is the single largest cause of engagement delay, and flagging it early is more useful than reporting it late.
Engagements work better when both sides commit
We are direct about this on the first call, because engagements that fail almost always fail on the client side of these four items — and that is a poor outcome for everyone.
- A named owner with authority to gather data and make decisions
- Complete data within the agreed window, or an early conversation about why not
- Honesty about what actually happens versus what the policy says — we are not there to catch anyone out
- The right people in the room for the findings presentation
- A decision on the remediation plan, even if the decision is to defer part of it
If we are not the right firm for a piece of work, we would rather say so at the scoping call than discover it in week four.
Next step
Start with a 30-minute scoping call.
No preparation needed. Describe the situation and we will tell you what fits.