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

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US Beacon

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