Products / Plan Operations Audit

Catch setup errors before a claim is paid wrong.

Plan Operations Audit checks the plan build your team uses for claims setup against the carrier’s benefit summary. It flags every copay, deductible, limit and exclusion that does not match, points to the row behind it, and drafts the corrections.

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TPAsFund officesBenefits operations

Plan Operations Audit2027 benefit summary vs. plan build

Complete · 45 rows

Starting0:00

Audit 0 Match 0 Mismatch 0 Missing

BenefitSummaryPlan buildStatus

Office visits

PCP visit copay$25$25Match

Specialist visit copay$40$45Mismatch

Urgent care copay$50$50Match

Limits and deductibles

Out-of-network deductible$1,500$1,500Match

Chiropractic visits20/yrblankMissing

Emergency room copay$250$250Match

Specialist visit copayMismatchRow 112

The summary says $40. The plan build has $45.

DismissConfirm

Should be: $40

Showing 6 of 45 rowsExport marked-up plan build (1)

Illustrative example. Fictional plan and values.

Who it’s for

TPAs administering carrier plans
Fund offices
Benefits operations teams

When a benefit summary arrives at renewal and someone has to confirm the claims setup matches it.

The problem

The setup drifts from the summary.

01The benefit summary and the plan build are kept by different teams, in different formats, on different schedules.
02Checking hundreds of benefit lines by hand takes days per plan, so it happens late or not at all.
03A mismatch nobody catches becomes a claim paid wrong, then an appeal, then rework.

What it does

Every benefit line checked. Every finding traced.

Reads both sides in full

Every line in the benefit summary, standard values and plan deviations included, and every row of the plan build.

Flags every difference

Copays, deductibles, limits and exclusions are marked Match, Mismatch, Missing or Uncertain.

Points to the source

Each finding names the benefit and the row it came from on each side.

Drafts the corrections

Confirmed findings export as a marked-up plan build, with comments for the carrier drafted for review.

What you get

Outcomes your team and your board can see.

Fewer claims paid wrong

Mismatches are caught before claims are paid against them.

Days back per renewal

The audit runs in minutes. Your team reviews findings instead of hunting for them.

A record you can defend

Every correction traces to a line in the benefit summary.

How it works

Three steps. One checkpoint.

Step 1

Upload

Upload the carrier’s benefit summary and your plan build.

Step 2

SyncroDoc reads and checks

Every benefit line is compared, and each difference is flagged with its row.

Step 3

Your team decides

Confirm or dismiss each finding before anything goes back to the carrier.

How the platform works →