Pandemic Risk Management and Claim Settlement Solutions
From our recent work with Risk Managers, Claim Managers, Brokers and Attorneys, many organizations are using the time during the pandemic to review the costs of their programs and accelerate claim settlements.
Total Cost of Risk
Since developing our Total Cost of Risk (TCOR) application for Middle Market (defined as organizations having revenues $10 Million to $1 Billion) and Large ($1 Billion+) organizations, we’ve expanded our operations to include customized versions to meet the specific criteria of the client.
We have looked at over 150 programs since the beginning of this year, and we have been able to observe and identify the root causes of claims and expected claims by the type of program. All of our recent experience has been updated in our free TCOR application for Risk Managers, Brokers and associated colleagues to use in analyzing the programs. We are then assisting clients by customizing the results for various reporting, compliance and marketing needs.
Accelerated Claim Solutions
We have seen many clients use the time during the pandemic to find solutions to their most difficult claims. By bringing a unique approach and an extensive “results-oriented” benchmarking capability with our RiskPro® data and technology to our clients, we are delivering outstanding results to show the real value of the claim. In our hundreds of projects this year, we have been able to help our clients close 60-80% of their legacy cases, and have reduced the outstanding reserves from 20-40% from the start of the project. Claim Managers and Adjusters have utilized our What Is Your Claim Worth applications for consistency and vital proprietary RiskPro® and industry information to benchmark their claims.
Medicare Set Asides (MSA) and Lien Resolutions
With over 30 years of experience in administering the entire Enterprise Risk Management (ERM) and claim management settlement solutions process, our teams continue to support our clients with independent objective settlement analyses. Using our technology and integrated resources, we have cut the time for analyzing an MSA case to 7-10 days, and obtain a Medicare approval within 21-28 days. Our new technology for lien management allows us to report a case within 24 hours, and depending upon Medicare response obtain their results within 3-10 days. By eliminating time during this difficult phase of the process, the claim settlement negotiations are significantly enhanced. As an example, our Medicare Lien team reduced a portfolio of Medicare Conditional Payment liens over $350,000, and finalized the liens with settlement details for a major national law firm within 30 days!