Cover Medical Audit
Our Services

Medical Audit

Picture Medical Audit


The service of medical audit that MCO offers implies critical and periodical evaluation of medical quality delivered to client´s beneficiaries, through revisions of healthcare procedures given by providers hired to such effect.

  • Failure to update patient's daily evolution in his clinical record.

  • Over-invoicing of medicines and supplies.

  • Unnecessary requests of tests and practices.

  • Medical and nursing miscalculations.

  • Inhuman manner displayed by professionals and personnel.

  • Lack of attention and lack of management dealing with complaints.

  • Inadequate infraestructure of premises.


  • Lower cost in hospitalization due to early discharge.

  • Audit's denial to unnecessary hospitalization procedures.

  • Burocratic compliance, in due time and manner, in submitting benefits that can be reimbursed.

  • Direct communication, information and emotional support to hospitalized beneficiaries and their families. Continuous reporting to central audit sectors of trade-union run medical insurance as required.

  • Contribution of on-site and written and information in shared audits.

  • Supervision when referring patients to mayor complexity centers.

  • Supervise the execution of the Basic Medical Plan as a whole, specially the execution of prosthetic inputs, according to said plan.

  • Possibility of auditors partial or full time disposal in selected companies.


  • To give more efficient healthcare assistance.

  • Maximize performance and control of costs.

  • Optimize quality of service and beneficiaries' satisfaction.

  • Alert clients and comment on every possible deflection of current regulations.

  • Contribute to development of client´s progress.


We have a medical-administrative team specialized in billing control from service suppliers to financial backers, with the purpose of monitoring and making the pertinent deductions.

The service guarantees an excellent service and transparency standing as a control previous to invoicing payments. This is performed outwardly.

This pattern produces a direct economic impact on the company´s unjustified expenditures.

Superintendencia de Servicios de Salud - Órgano de Control de Obras Sociales y Entidades de Medicina Prepaga - 0800-222-SALUD (72583) - No de Registro de Prestador SSSALUD: 1519/13