Bmi Audit Services
BMI Audit Services, founded in 1998 and headquartered in South Bend, Indiana, provides dependent eligibility verification, medical and prescription claims audits, and implementation audits for self-insured health plans of organizations with 50 to over 500,000 enrolled members, using proprietary AUDiT iQ™ software and the BMI Verify Portal.
- Company typePrivate
- Founded1998
- HeadquartersSouth Bend, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What Bmi Audit Services does
BMI Audit Services is a privately held professional services firm headquartered in South Bend, Indiana, founded in 1998 to provide independent healthcare benefits audits for self-insured health plans. The company delivers three core engagement types: dependent eligibility verification audits that screen enrolled dependents against plan eligibility rules, medical and prescription claims audits that review claims adjudication by third-party administrators (TPAs) and pharmacy benefit managers (PBMs) for accuracy, and pre-/post-implementation audits that test whether TPA and PBM system configurations align with the plan's documented design. Delivery is anchored by AUDiT iQ™, a proprietary audit software platform that analyzes 100% of medical claims for compliance, eligibility, and fraud, waste, and abuse indicators, and is supported by the BMI Verify Portal for member-facing document submission and status tracking. As of January 2024 the firm had executed over 5,000 audits cumulatively — 2,760 dependent eligibility audits and 2,246 medical and Rx claims audits — and reported a 95.65% customer experience score with 84.42% of customers willing to serve as a reference. Documented engagements include results such as 159 ineligible or unverified dependents removed at a large regional hospital yielding $795,000 in first-year savings and a 3,015% ROI, and identification of an average 9.5% ineligible dependent rate across 2022-2024 audits.
BMI serves organizations ranging from 50 to over 500,000 enrolled health plan members across more than 25 verticals including education, healthcare, government, labor unions, banking and finance, transportation and logistics, manufacturing, and retail. Revenue is generated through professional services engagements priced on a quote basis, with contracts structured on a multi-year cadence and influenced by verification approach, household count, plan count, and plan type. The go-to-market motion is sales-led, combining direct outreach to plan sponsors, partner channels through insurance brokers and employee benefits consultants, and inbound demand generated through an integrated content marketing program that includes a long-running blog (Audit Findings of the Month, published since 2011), a savings calculator, a resource center, and continuing education programs approved for insurance CE credits and CEBS Compliance Credit courses.
BMI is organized as BMI Audit Services, LLC, an Indiana-domiciled limited liability company with no disclosed parent, holding entity, or institutional backing. The firm employs between 11 and 50 people and operates solely in the United States. In 2024 the company announced a rebranding to Lumelight, repositioning its service identity toward broader benefits oversight and plan sponsor fiduciary stewardship while continuing to deliver the same core audit offerings. The firm has no disclosed funding rounds, no subsidiaries, no patent portfolio beyond registered trademarks for AUDiT iQ™ and the BMI Verify Portal, and no documented AI or machine learning capability in its product stack.
Bmi Audit Services firmographics
Firmographics- Name
- Bmi Audit Services
- Legal name
- BMI Audit Services, LLC
- Website
- https://bmiaudit.com
- Company type
- Private
- Founded year
- 1998
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- BMI Audit Services, founded in 1998 and headquartered in South Bend, Indiana, provides dependent eligibility verification, medical and prescription claims audits, and implementation audits for self-insured health plans of organizations with 50 to over 500,000 enrolled members, using proprietary AUDiT iQ™ software and the BMI Verify Portal.
- Ownership category
- akta.pro rank
Bmi Audit Services industry classification
Industry- Product category
- Healthcare Benefits Auditing
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (525120)
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Claims Administration & Payment Integrity (Medical/Dental/Vision) (HLAEALAD)
- akta.pro secondary industries
- Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises) (HLAEALAJ), Self-Funded Employer Plan TPA (ASO Administration) (HLAEALAA)
Keywords
Where Bmi Audit Services is headquartered
LocationHeadquarters
- HQ city
- South Bend
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Bmi Audit Services business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales
Revenue model
- Healthcare Audit Services: BMI generates revenue through providing professional audit services including dependent eligibility verification audits, medical and prescription claims audits, and implementation audits. Pricing is quote-based and influenced by factors such as verification approach and household count.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Quote-based pricing for audit services |
Go-to-market motion1 record
Distribution channels3 records
Marketing channels6 records
Bmi Audit Services product offering
Product offeringCore offering
BMI Audit Services provides independent, third-party healthcare benefits auditing for self-insured plan sponsors. The firm conducts dependent eligibility verification, medical and prescription claims audits, and pre/post-implementation audits of TPA and PBM plan configurations, using its proprietary AUDiT iQ™ software and the BMI Verify Portal for secure member document collection.
Product overview
BMI Audit Services is a specialized healthcare audit company that offers three core audit services: Dependent Eligibility Verification Audits, Medical + Prescription Audits, and Implementation Audits. These services are delivered using the proprietary AUDiT iQ™ software and supported by tools including the BMI Verify Portal for member document submission, a Resource Center with FAQs and video content, and a savings calculator. The company also provides continuing education programs and publishes monthly audit case studies. Founded in 1998, the company has conducted over 5,000 audits and rebranded to Lumelight, while continuing to operate under the BMI Audit Services brand.
Differentiator
Problem solved
Functional benefit
Brands
- Lumelight: A rebranded entity under which BMI Audit Services now operates, offering a broader commitment to simplifying benefits oversight and safeguarding every dollar for plan sponsors.
- AUDiT iQ™
- BMI Verify Portal
Products and services
- Dependent Eligibility Verification Audits Verifies whether dependents enrolled in an organization's self-insured health benefits plan are eligible per the plan's rules by reviewing supporting documentation such as birth certificates, marriage certificates, and tax returns. Designed for employers, labor unions, government entities, and other plan sponsors.
- Medical + Prescription Claims Audits Reviews healthcare and prescription claims for self-insured plans to identify inaccurate payments, processing errors, fraud, waste, and abuse by third-party administrators (TPAs) and pharmacy benefit managers (PBMs). Targets plan sponsors seeking to validate claims administrator performance.
- Implementation Audits Pre- or post-implementation audits that test whether TPA or PBM healthcare plan configurations (benefits, limitations, deductibles, copays, exclusions) align with the plan's documented design. Targeted at plan sponsors undergoing changes to benefits, transitioning to self-insurance, or changing administrators.
- AUDiT iQ™ BMI's proprietary software that analyzes 100% of medical claims to test for plan compliance, eligibility, and potential fraud, waste, or abuse, and produces comprehensive audit reports with cost-saving recommendations. Used internally by BMI as part of its audit service delivery.
- BMI Verify Portal Online portal that allows plan members to securely submit verification documents and plan sponsors to access project status and audit results during a dependent eligibility verification engagement.
Quantifiable outcome
- Average 9.5% of enrolled dependents are found to be ineligible for benefits (2022-2024 data)
- +4 more outcomes
Companies that use Bmi Audit Services
Customer profileNamed customers6 records
Segments15 records
Ideal customer profiles3 records
Bmi Audit Services technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature3 records
Bmi Audit Services partnerships and signals
Strategic signalScale indicators9 records
Recent moves7 records
Expansion highlights5 records
Bmi Audit Services competitors and assessment
Company assessmentEmerging players
- Zywave: Zywave offers insurance and benefits technology, including analytics tools for brokers and employers, an adjacent competitor in benefits oversight workflows.
- Springbuk: Springbuk provides health benefits analytics and data intelligence for employers, intersecting with BMI's audit-driven insights and benefits oversight positioning under the Lumelight rebrand.
- Benefitfocus: Benefitfocus provides benefits administration technology that touches dependent eligibility and plan configuration, intersecting with BMI's implementation audit use cases.
Broad incumbents
- Mercer: Mercer is a global consulting firm whose benefits advisory practice encompasses vendor audits, dependent eligibility reviews, and TPA performance assessments for large employers.
- Change Healthcare (Optum): Change Healthcare, now part of Optum, offers payment integrity and claims editing at scale across payers and PBMs, representing a broader incumbent alternative to BMI's audit services.
- Aon: Aon's health benefits consulting includes audit-related services and broker-driven vendor reviews for self-funded plan sponsors, competing indirectly via its broker relationships.
Direct peers
- Cotiviti: Cotiviti provides payment integrity and claims accuracy solutions for health plans and PBMs, directly overlapping with BMI's medical and prescription claims audit services.
- ClaimDOC: ClaimDOC provides independent claims auditing and cost containment services for self-funded health plans, competing in the same claims payment integrity category as BMI.
- Pareto Intelligence: Pareto Intelligence offers analytics and audit services for self-funded employers, addressing similar pain points around dependent eligibility, claims accuracy, and implementation auditing.
- SCIO Health (now emids): SCIO Health, acquired by emids, delivers payment integrity, risk adjustment, and claims analytics services, overlapping directly with BMI's claims audit offering.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights7 records
Customer concentration
Bmi Audit Services social profiles
Digital presenceBmi Audit Services financial estimates
Financial estimateRevenue estimate
Valuation estimate
Bmi Audit Services leadership team
Management profileNumber of profiles
Bmi Audit Services funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Bmi Audit Services M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Bmi Audit Services
What does Bmi Audit Services do?
BMI Audit Services provides independent, third-party healthcare benefits auditing for self-insured plan sponsors. The firm conducts dependent eligibility verification, medical and prescription claims audits, and pre/post-implementation audits of TPA and PBM plan configurations, using its proprietary AUDiT iQ™ software and the BMI Verify Portal for secure member document collection.
Is Bmi Audit Services a public or private company?
Bmi Audit Services is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Bmi Audit Services founded?
Bmi Audit Services was founded in 1998. It employs 11 to 50 people.
Where is Bmi Audit Services based?
Bmi Audit Services is headquartered in South Bend, United States, in the North America region.
How does Bmi Audit Services make money?
One revenue line is on record: healthcare Audit Services.
Who are Bmi Audit Services's main competitors?
Emerging players on record are Zywave, Springbuk and Benefitfocus. Broad incumbents are Mercer, Change Healthcare (Optum) and Aon. Direct peers are Cotiviti, ClaimDOC, Pareto Intelligence and SCIO Health (now emids).
Does Bmi Audit Services have an API?
No public API is recorded for Bmi Audit Services.
What industry is Bmi Audit Services in?
Bmi Audit Services's product category is Healthcare Benefits Auditing. Its primary akta.pro industry code is HLAEALAD, Claims Administration & Payment Integrity (Medical/Dental/Vision), with a secondary code of HLAEALAJ, Compliance, Reporting & Regulatory Administration (ERISA/ACA/No Surprises). Its NAICS code is 524292 and its SIC code is 6324.