Company Profile
IntegriGuard, LLC
Company Overview
Since its formation as an independent corporation in April 2003, IntegriGuard, LLC (IntegriGuard) has grown to be a national leader in the field of detection and deterrence of improper payments, fraud, and waste.
We provide tailored solutions to safeguard our clients’ program benefits using state-of-the-art data aggregation and data analysis, as well as detailed audit and investigative techniques to provide consistent, accurate, and timely results. We work with the Centers for Medicare & Medicaid Services, Office of Inspector General, Federal Bureau of Investigation, and offices of the United States Attorney.
Our wealth of skills and experience, developed over years of conducting program safeguard activities for the Medicare Program, are directly relevant to many federal programs.
Our multi-disciplined team of professionals utilizes forensic audits, compliance solutions, targeted investigations, and advanced analytics to identify improper payments and prevent future payment errors. To find the right solutions for our clients’ needs, we depend on our core competencies: fraud detection, audit, investigation, analysis, medical review, and compliance programs.
IntegriGuard regards quality and customer satisfaction its top priority; the company is ISO 9001:2000 registered and URAC accredited as an Independent Review Organization. Headquartered in Omaha, Nebraska, IntegriGuard operates from other offices in Maryland and Florida.
Company History
In 1999, IntegriGuard emerged as a division of Lumetra, the California Quality Improvement Organization.
In April 2003, IntegriGuard, LLC, officially formed as Lumetra's first wholly owned subsidiary.
In May 1999, the Centers for Medicare & Medicaid Services (CMS) awarded IntegriGuard, as one of 13 companies nationwide, a Program Safeguard Contractor (PSC) contract under the new Medicare Integrity Program. In winning this designation, IntegriGuard became eligible to bid on federal task orders for detection and prevention of healthcare fraud and abuse.
In November 1999, we won our first PSC contract to conduct onsite visits to verify enrollment information for community mental health centers. The task order was later modified to include a large sample of claims for medical review.
In July 2001, IntegriGuard was also one among eight companies nationwide to receive a Medicare Managed Care Program Integrity Contract (MMC-PIC) from CMS.
CMS awarded IntegriGuard a new designation as a Qualified Independent Contractor (QIC) in September 2004. As one of eight QICs in the nation, IntegriGuard is eligible to bid for Medicare second-level appeal work.
IntegriGuard became one of eight companies nationwide in August 2005 to be designated as a Medicare Drug Integrity Contractor (MEDIC) by CMS. As a MEDIC, IntegriGuard is eligible to competitively bid on tasks intended to provide benefit integrity support in audit, oversight, and anti-fraud and abuse efforts associated with the Medicare Prescription Drug Benefit (Medicare Part D).
In January 2007, IntegriGuard, LLC became a schedule contractor for the General Services Administration (GSA). This contract award allows IntegriGuard to procure Enrollment & Eligibility, Fraud, Audit, and Investigative work through the GSA purchasing system.
Notable Accomplishments / Recognition
Since 1999, the Medicare program has contracted with IntegriGuard to conduct work in fraud detection and deterrence. IntegriGuard’s efforts have produced billions in savings for the Medicare Trust Fund.
Benefits
Medical Insurance
Medical insurance is effective on the first day of employment. Employees have a choice of two UnitedHealthcare PPO plans. IntegriGuard pays 85% of the premium for each eligible employee. IntegriGuard pays a competitive portion of the premium for eligible, enrolled dependents.
Dental Insurance
Insurance through MetLife becomes effective the first day of the month following date of employment. IntegriGuard pays 85% of the premium for each eligible employee. IntegriGuard pays a competitive portion of the premium for eligible, enrolled dependents.
Vision Insurance
A vision plan through VSP becomes effective the first day of the month following date of employment. IntegriGuard pays 85% of the premium for each eligible employee. IntegriGuard pays a competitive portion of the premium for eligible, enrolled dependents.
Flexible Spending Account
IntegriGuard offers a savings account where employees can have deductions taken on a pre-tax basis to pay for medical and dependent care expenses.
Long-Term Disability Insurance
IntegriGuard provides insurance that may pay a benefit of up to 60% of an employee's monthly salary after a 90-day eligibility period. The coverage becomes effective the first day of the month following date of employment. IntegriGuard pays the premium in full for each eligible employee.
Short-Term Disability Insurance
Employees may purchase voluntary short-term disability insurance through payroll deduction. Employees are eligible for a weekly benefit due to loss of wages upon accident or illness. Rate of benefit amount varies by individual.
Life Insurance
A group Life and Accidental Death and Dismemberment Policy covers every eligible IntegriGuard employee. The life insurance benefit is one times the annual salary rounded up to the nearest thousand. The coverage becomes effective the first day of the month following date of employment. IntegriGuard pays the premium in full for each eligible employee. Employees may purchase additional life insurance through payroll deduction.
Paid Time Off (PTO)
PTO benefits accrue on a payroll period basis. Annualized PTO accruals based on years of service are: 0 to 3 years = 18 days, 4 to 8 years = 25 days, 9+ years = 30 days. PTO time for part-time employees is prorated. PTO is accrued at the end of each pay period of service.
Holidays
IntegriGuard observes the following holidays: New Year’s Day, *Martin Luther King Day, *President’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Day after Thanksgiving Day, Christmas Eve, Christmas Day, and one Floating Holiday. *Employees housed in the Florida EDS offices will observe New Year’s Eve Day and Good Friday instead of these days.
Compensation Base Pay
All jobs are market priced and placed in salary grades. Salary Grades are adjusted each year to reflect market increases. All employees participate in a company-wide focal review at the same time each year. Merit increases are awarded based on individual performance.
Retirement Plans
IntegriGuard offers two kinds of retirement plans to employees: a 401(k) tax deferred salary reduction plan and a defined contribution profit sharing plan. Both plans offer a selection of mutual funds offered through Vanguard.
401[K] Tax Deferred Payroll Savings Plan
Through this plan employees can invest a portion of their salary for retirement. Participation is effective the first day of the month following date of employment. In 2007, maximum deferrals for those age 49 and younger is $15,500, and for 50 and older $20,500.
Defined Contribution Profit Sharing Plan
Upon completion of one year of service, IntegriGuard will begin to contribute an amount equal to 8% of base salary into a defined contribution pension plan. Investments are self-directed in the same selection of mutual funds available in the 401(k) plan. Vesting is structured according to a graded schedule with 100% vesting at five years in the plan.
Educational Assistance
Full-time employees are eligible to participate, upon completion of their introductory period, for financial reimbursement of approved work-related classes from an accredited institution. The maximum reimbursement is $500 per academic term.
Educational Leave
Employees who need to maintain a certificate/licensure (ART / LVN / RN / RRA / MD) are eligible for a maximum of three days of educational leave with pay during each year of employment after 12 months of continuous full-time service.
Employee Assistance Program
The Employee Assistance Program (EAP) provides eligible employees and their dependents up to three sessions of confidential, professional counseling per year. This is provided at no cost to the employee and is effective the first day of the month following date of employment.
This is a summary of the current benefits offered by IntegriGuard and cannot replace or modify the provisions of the individual plan documents or written policies.
Revised January 23, 2007