Claims Intelligence Services
Having the right technology in place is critically important in the effort to streamline business processes of insurance organizations. The right technology significantly reduces human error, speeds form validation, automates reminders, and improves analysis and outcome quality. InHealth’s Claims Intelligence Solution takes this automation a step further to provide complete field, consistency and relationship review within a form along with straight through processing on common forms. InHealth’s professional services step in to provide full support on complex cases.
There are however, many instances where our clients require additional support to help them achieve their goals relating to the performance of their claims management team.
InHealth’s services team provides expert knowledge and professional services, including:
Typically clients begin with a review of claims related processes. Our Professional Services team then works closely with client team leaders to develop and implement best practices for claims management. InHealth’s software is also configurable to support best practices and the unique requirements of your organization.
InHealth Review Services deliver file analysis and direction to assist your claims team in making approval decisions on the claim components upfront; leading to resolution at the earliest opportunity.
InHealth’s team of professionally managed, guideline certified, clinical analysts provide expert objective response at multiple service levels; from individual form reviews through multi-disciplinary summary reports that chronicle and summarize the rehabilitative process and include recommendations to facilitate or stave off any conflict resolution. Our analysis and recommendations provide the benchmark for quality outcome decisions and ensure value for claim dollars spent.
Our full list of specialized review services includes:
- Form reviews - acute/sub-acute treatments, chronic treatments and assessments
- Catastrophic assessments and file/form reviews
- Comprehensive file reviews (includes retrospective file reviews, prospective file reviews, invoice reconciliation audits) by one or more analysts
- File summary reports
- Pre and post Insurer’s Exam (IE) reviews
All services are provided by InHealth Guideline Certified Analysts and support eligibility and entitlement decisions.
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