CONTACT US: 562.334.7980



Segal Medicare Experts (SME) is a premier consulting firm specializing in Medicare Advantage and Part D. We work with Medicare Advantage leaders in Health Plans, Field Marketing Organizations and Providers who want to develop effective solutions to achieve better results.

Our experts have in-depth knowledge of the Centers for Medicare & Medicaid Services (CMS) programs, policies, and regulations through working as both consultants and former regulators. Our team is 100% dedicated to the Medicare Advantage and Part D industry, which allows us to bring both expertise and experience to each and every project.

At SME, we understand that each organization has its distinct needs, and we are committed to serving those through carefully crafted strategies specific to each client. Our team uses a 360-degree view acknowledging all aspects of the company: people, processes, technology, and governance. This ensures taking to account all moving parts so we can create effective solutions. Our team delivers results by using their insights to facilitate feasible and viable solutions for success.

Our team delivers results by using their insights, passion and skills.

We look forward
to working with you.

shelley segal

CEO, Segal Medicare Experts

Having a difficult time getting started with your CPE Audit?

Let Segal Medicare Experts help you to surpass any obstacles.

SME has a comprehensive team of CMS Program Audit experts, including SME leaders who previously worked at CMS and have first-hand experience conducting CMS Program Audits.

Additionally, SME respects and appreciates how important it is for MAOs, PDPs, and MMPs to be front and center with CMS, leading their performance during a Program Audit. This is why SME uses a behind-the-scenes approach, which provides you with full audit support, including:

✓ Clarification of audit requirements throughout the audit process

✓ Review of documentation, including data universes, prior to submission, during fieldwork, and if needed, throughout validation and close out

✓ Training associates and FDRs on strong audit performance skills

✓ Best practices in conducting and leading tracer reviews

✓ Assistance with technology and facility set up to ensure a smooth audit experience, including connectivity with your FDRs

✓ Taking notes and tracking deliverables throughout fieldwork

✓ Guidance for and review of any corrective action required as a result of the audit

✓ Drafting communications to keep FDRs, leadership, employees, and key stakeholders informed of the audit process and outcomes.

Regardless of your current state of audit readiness, adding Segal Medicare Experts to your CMS Program Audit team provides your organization and associates with additional assurance by an expert professional team to conduct your annual CPE audit.

SME will help you prepare documents in advance, to avoid that last-minute scramble after you receive a CMS audit notice.


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Call us or write to us today. Office: 562.334.7980



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