Solution

Solutions to Claims Management Problems Solving claims management problems is perhaps one of the most critical functions for our firm and one we have grown to specialize in over the years. When claims are mismanaged the cost escalates, and the issues become more difficult to resolve. We offer a comprehensive solution to claims management issues based on clear communication between your staff and the insurance carrier adjusters and with specialists we retain to provide review and claim path intervention.

Our Mission

It is our ultimate goal to provide clients with comprehensive claims handling oversight with includes the following action points:

Monthly claims oversight

Quarterly claims reviews

First aid reviews

MPN compliance

• UNIT STAT Reporting • Modified Duty, Early return to work programs • Post termination advice • 24-7 HR consulting • OSHA compliance • Loss Control Fraudulent Claims Defense • Does your carrier assume responsibility when a claim is made by an ex-employee? • Who is responsible for proving injury? • What does a claimant have to reasonably prove when a claim in denied? • Who is responsible for defending the claim? Tools for Combating Fraud Claims • Effective investigation technics • Immediate medical intervention (documentation) • Delay leading to denial of state benefits • Quick legal intervention • Private investigation services • Applicant Med-legal dispute process • Threat of Current Employment engagement The Desired Results Claims management problems can soar to sky levels if not managed well. Thus, we do want that: • Fraudulent claims are unpaid. We will ensure to assist clients each time there are disputes when it comes to claims processing to avoid fraud. • Claim paths are reviewed and where appropriate… corrected. Our specialists understand when a claim is headed in the wrong direction and can communicate with the adjuster in language they understand how to get on the right track. • We will monitor the entire claims management system to ensure that our clients will pay the correct amount and are enlightened about the status of different claims. We will guarantee that claims are not inflated and that everything is accurate. • We will provide staff training to help your company aid in the positive outcome. >.

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