Engagement & Investment
An enterprise program, priced to the value it protects.
InsuredAudit is delivered as a multi-year program, deployed inside your environment. Investment is anchored to the improper-payment, overturn, and audit exposure it makes defensible -- not to a per-seat list price.
The model
| Component | Indicative investment | What it covers |
|---|---|---|
| Implementation & program stand-up One-time |
$4M – $6M | Deployment into your environment, X12 / FHIR / HL7v2 / NCPDP feed integration, clinical-criteria library configuration, validation, and go-live. |
| Platform subscription Annual · 5-year term |
from $5M / yr | The full platform -- UM decisioning record, advocacy engine, tamper-evident evidence ledger, member portal, APIs. Sized to membership / claims volume; ~4% annual escalator. |
| Managed Advocacy & Integrity Operations Annual |
$1.5M – $3M / yr | Ongoing criteria tuning, CMS / state regulatory updates, expert reviewer support, and audit / appeal assistance. |
| Court-Ready Evidence (CREB™) usage Per bundle · non-contingent |
by volume tier | Signed, court-ready evidence bundles on demand. Priced per bundle by volume -- never a percentage of recovered dollars. |
Illustrative program (5-year total value)
Large MCO
$45M – $55M
~$5M implementation + ~$6M/yr platform + ~$2M/yr managed operations + usage. Roughly a third is services.
Mid-size plan
$20M – $30M
The same structure, scaled to membership and claims volume.
How we anchor the number
- Priced against your documented exposure -- improper-denial and overturn leakage, audit and litigation risk, program-integrity recovery.
- Target a 3–10× value-to-investment ratio; for a large plan that exposure is typically tens to hundreds of millions.
- Non-contingent -- we are a detect-and-evidence platform, not a recovery service that takes a cut.
What the program buys you (and why it lasts)
- InsuredAudit becomes your system of record for UM defensibility -- every decision criteria-anchored, reproducible, and court-ready.
- Runs inside your infrastructure; PHI never leaves your HIPAA boundary.
- A 5-year term with predictable escalators, expansion tiers, and a dedicated operations partner.
Next step: a no-fee scoping working session. We size the program to your book and model the value against your own determinations. Request at insuredaudit.com/connect.
Figures are indicative and sized per engagement to plan membership, claims volume, and scope; they are not a quote. Confidential -- prepared for discussion.