Audit Explanation of Benefits (EOB’s) Provider Guard ™

  • Identify inappropriate payer access.
  • Prevent and eliminate the existence of revenue-reducing agreements.
  • Detect discounts taken for out-of-network benefits.
  • Analyze payer agreements that included Workers Compensation Access.

Many practices have managed care agreements that have been in place for decades. These agreements are with payers and networks that may have been purchased or sold since the agreements were executed. This leads to what we refer to as, “Blind and Silent Virus Agreements”. This allows many plans to access discounts through managed care agreements with no financial incentives built into the plans.

The development of regional plans joining national networks allows thousands of payors to access provider discounts within Virus Participating Provider Agreements. This becomes exceptionally difficult for providers to distinguish legitimate payor plans. As a result, medical providers have no way to protect themselves from abuse by these national agreements unless proactive decisions are made to prevent the occurrence. Provider Guard™ is a proven product for monitoring your managed care agreements and Explanation of Benefits (EOBs) for protection against inappropriate payor access. We will make recommendations as to which agreement should be renegotiated, which should be left alone and which might require termination.


If you are interested in Medical Management Association and have questions or comments – we are eager to hear from you.

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Medical Management Association

394 Williamstowne, Suite 201
Delafield, WI 53018