The role of insurance companies in healthcare is changing in many countries from passive handling of reimbursement claims to actively directing the pathways of treatment. An insurance company may have high level of expertise in medico-legal aspects of health insurances and in insurance mathematics, but they seldom have a true understanding of how the service providers such as hospitals operate.

There are numerous ways a hospital can overcharge and extend the spectrum of diagnostics and treatments provided to a patient. All this is taking place in the medical grey area, where decisions and indications are relative, and where insurance companies quite often get the short end of the stick.

Our team has the experience and expertise to analyse insurance claims and charges in depth, to follow average treatment pathways and to identify patterns of unnecessary diagnostics and overtreatment by hospitals.