US BEACON is an independent medical and pharmacy claims compliance firm that protects self-funded health plans, TPAs, and stop-loss carriers from costly overpayments and non-compliant billing practices.

We perform pre-payment and post-payment claim audits, plan document reviews, and fiduciary compliance consulting to help plan sponsors meet their ERISA obligations and enforce the Transparency in Coverage and CAA 2021 requirements.

Our line-by-line clinical audits uncover:
	•	Upcoding and unbundling
	•	Duplicate or non-billable charges
	•	Fraud, waste, and abuse
	•	Billing irregularities and medical necessity errors

With an average 30–40% additional savings beyond network repricing and a less-than-0.25% appeal rate, US BEACON delivers measurable, compliant results.

We offer flexible pricing models — PEPM (per employee per month) or percentage of savings — depending on the client’s needs and claims volume.

Independent. Unbiased. Transparent.
US BEACON exists to protect the plan, protect the patient, and preserve every healthcare dollar.

US Beacon

Org chart

Teams

Offices