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Centaur for Employers

Centaur for Self-Insured Employers

Let us conduct a hassle-free vulnerability assessment on a sample of your paid claims today and be amazed at your revenue opportunity.

Industry Leading Guarantee

As with all Sharecare Payment Integrity products and services, we guarantee findings that will produce financial benefits to your organization through increased revenue and/or costs avoidance that exceeds our cost to you, or our services are free.

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Self-Insured Employers are Under Attack and Overpaying for Healthcare

Third Party Administrators (TPA’s) are overpaying Self-Insured Employer’s healthcare claims riddled with Fraud, Waste, and Abuse (FWA) each day without being audited externally for accuracy. Left unchecked, TPA’s report near perfect levels of accuracy in fighting FWA. In reality, no one is policing their work and millions are left on the table. How does this happen? Employers do not have the resources or teams necessary to audit their TPA’s. It is understandable to believe your trusted advocate is operating at high levels of success, and many do not know this problem even exists.

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Fraud, Waste, and Abuse (FWA) in Healthcare is to Blame

FWA is averaging 19% in healthcare on a national basis each year. Insurers spend $2-5 billion annually on solutions to mitigate FWA in the US, but catch less than 10% of fraudsters. Because FWA is perceived as a low risk/high reward crime, new fraudsters and fraud schemes appear every day. Employers with Self-Insured Health Plans may be forced to charge higher premiums to mitigate the impact of FWA to their bottom line. FWA in healthcare has become a $300B problem in the US today.

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What’s the Solution? The Sharecare Payment Integrity Centaur

The Centaur’s AI-based platform is designed for self-insured employers to automatically and economically find claims that should have never been paid due to emerging healthcare claims fraud, waste, and abuse issues. Our all-inclusive platform utilizes patent-pending AI-based technology to uncover new insights and schemes not possible with traditional investigative processes and procedures. The Centaur finds overpayments sent to providers through your TPA. 5-8% of total claim volume is typically found across the board. Sharecare will work with you to collect on these overpayments and recover. As one example, 10,000 employees would resemble a revenue opportunity of $5 million.
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