Us Beacon

Founded in 1995, 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.