Our available consulting services
- claimchk
- Apr 18, 2017
- 2 min read
Here is a summary of the consulting services that we make available to our clients. This type of assistance is offered to agents, brokers, risk managers and directly to business owners. For more information on their availability in your area, how each can be tailored to your needs with service quotes, please contact us at claimchk@gmail.com or by phone at 314-821-6382.
Services include:
A. RESOURCE MANAGEMENT – REFERRAL OF SPECIALISTS
Adjusters
Experts: Engineers, Chemists, Architects, Medical Mgmt.
Defense Attorneys
Reference materials
Surveillance investigators
B. AUDITS, EVALUATION & REVIEW
Analyze claim information and procedures for new accounts.
Review litigation files; suggest alternatives to save time and money.
Review medical files for medical management, utilization and effect on treatment.
Indemnity or wage loss damage analysis.
Review property losses for subrogation potential.
Track Reserve Development for retro rating evaluation.
Evaluate compliance with state regulations.
Assist with Self Insurance Feasibility study.
LOSS ANALYSIS
(Through examination of patterns, trends, predictable results.)
Injury types, accident patterns, safety control, location patterns,
and communication barriers.
Information for Safety programs, OSHA problems, bidding preparation, changing insurers.
Help establish meaningful and useful reserving (internal).
Updates to line manager on individual claims for safety committee, staff planning, employee moral, etc.
D. STAFF TRAINING
Understanding the claims process.
What to expect from the claims handler.
Data interpretation.
Effective Return-to-Work programs.
ADA compliance.
Coordinating the Safety Program with the claims process.
Dealing with medical providers.
Use of the Drug Screening Program.
E. SELF INSURANCE CONVERSION
Feasibility Study.
Staff evaluation.
Recruiting technical personnel.
Establishing systems and procedures.
Internal Claims Management
A. MONITOR CLAIM HANDLING
Setup and Design claim reporting & tracking system.
Focus attention on important claims.
Evaluate settlement proposals.
Make your claims a priority to the claim handler
Identify claim handling problems and trends (handler, office, state, jurisdiction, and mgmt.)
Coach claim reps with alternative ideas and methods.
Identify and track ineffective claim handlers for replacement.
Propose alternative settlement mechanisms where appropriate.
LIAISON BETWEEN MANAGEMENT & CLAIMS OPERATION
Save management time on settlement authorization.
Interpret claim and medical issues to mgmt.
Evaluate claims operation for compliance with mgmt philosophy.
Select and provide relevant reference materials for company use.
Enhance Return-to-work program to minimize indemnity costs.
SUMMARIZE, INTERPRET AND REPORT CLAIMS DATA TO MANAGEMENT
Design report format, summary spreadsheets, analysis for management.
Track status of all claims.
Prioritize claims for focus of mgmt time.
Conduct review meetings with management, agent and claims handler.
EARLY IDENTIFICATION OF PROBLEM CLAIMS.
Design quick notification system.
Assure early contact and control by claim rep.
Establish a preferred medical treatment network.
Institute effective Medical Management program.
Focus resources and attention on High Risk claims.
E. FRAUD CLAIM CONTROL
Verify claim legitimacy with line supervisor.
Provide customer with guidelines for early identification of questionable claims.
Identify resources for activity checks and surveillance.
Design new forms and procedures for internal control.
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