logoAbout Argusfirst

ArgusFirst is a highly-specialized mid-size investigative defense firm with a revolutionary proactive approach for all insurance lines. Our make-up consists of claims analysts, investigators (former federal and local law enforcement), certified medical coders and expert witnesses. Our services include: all claims related investigations, proprietary provider vetting for existing bill review platforms (front-end cost containment), comprehensive MPN analytical scrubs, fraud packaging and criminal prosecutions, experienced federal, state and local expert witness testimony, lien defense and SIU state compliance training, oversight & reporting.
Forged by our passion to combat fraud and abuse in our industry, we aligned our SIU expertise to become the foundation and philosophical driver of our corporate strategy. We have succeded in scaling SIU components by using technological advancements to allow for automatic exchange of information.
Our result driven and proven strategies led by industry experts, proprietary data, software and analytics has yielded significant favorable impact in sustained savings for the insurance industry. We believe that a partnership with claims, employers and law enforcement create a culture of prevention, accountability and integrity.

logoOur Services

SPEAR

SPEAR™ is a proprietary database built from decades of knowledge & experience with federal, state and local data. The most powerful tool in the industry in preventing unwarranted payment to non-qualified providers including; licensing issues, drug enforcement non-compliance, billing & coding violations, services rendered anomalies, prohibited referrals and other abusive or fraudulent practices.

LIEN DEFENSE

SPEAR is designed to help our clients on the front and back end of claim management. Because SPEAR identifies and prevents payments to abusive or fraudulent providers through Bill Review on the front end, our Lien Defense program effectively settles liens from these providers on the back end for either nominal or zero payment. A far better lien defense tool utilizing the lens of SIU experts.
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ARMOR

ARMOR is a revolutionary Provider Vetting Program seeking to protect and save significant medical claims costs. Supported by proprietary SPEAR™ software, it flags non-qualified providers proactively. Integrating ARMOR into your existing bill review, MPN, RFA and/or lien program platforms, you avoid paying providers needlessly.

SIU

Industry leading SIU experts are identifying, protecting and prosecuting Provider, Claimant and Premium Fraud. We offer full-service national compliance filings, mandated fraud reporting and on-site SIU compliance training seminars. We also offer an on-Iine training platform with certification.

FIELD INVESTIGATIONS

Field statement taking, clinic inspections, patient interviews, HD 4K Subrosa, Backgrounds, Medical Canvassing and Social Media Search & Capture. Our staff consists of experienced federal, state & local expert witness testimony for prosecutors involving cases for; Provider Billing & Coding and Major Healthcare Fraud Investigations.

ARMOR

ARMOR is a revolutionary Provider Vetting Program seeking to protect and save significant medical claims costs. Supported by proprietary SPEAR™ software, it flags non-qualified providers proactively. Integrating ARMOR into your existing bill review, MPN, RFA and/or lien program platforms, you avoid paying providers needlessly.

SPEAR

SPEAR™ is a proprietary database built from decades of knowledge & experience with federal, state and local data. The most powerful tool in the industry in preventing unwarranted payment to non-qualified providers including; licensing issues, drug enforcement non-compliance, billing & coding violations, services rendered anomalies, prohibited referrals and other abusive or fraudulent practices.

SIU

Industry leading SIU experts are identifying, protecting and prosecuting Provider, Claimant and Premium Fraud. We offer full-service national compliance filings, mandated fraud reporting and on-site SIU compliance training seminars. We also offer an on-Iine training platform with certification.

FIELD INVESTIGATIONS

Field statement taking, clinic inspections, patient interviews, HD 4K Subrosa, Backgrounds, Medical Canvassing and Social Media Search & Capture. Our staff consists of experienced federal, state & local expert witness testimony for prosecutors involving cases for; Provider Billing & Coding and Major Healthcare Fraud Investigations.

LIEN DEFENSE

SPEAR is designed to help our clients on the front and back end of claim management. Because SPEAR identifies and prevents payments to abusive or fraudulent providers through Bill Review on the front end, our Lien Defense program effectively settles liens from these providers on the back end for either nominal or zero payment. A far better lien defense tool utilizing the lens of SIU experts.
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