First Party Casualty

First Party Casualty Solutions

First Party Services & Solutions

MedFlow Technology

Our proprietary MedFlow Technology is the backbone of all our First Party services. Not only does it allow full visibility into the entire life of the claim, but its entirely electronic internal workflow provides easy access and organization of all claim data and medical documentation.

  • Case Progress Visibility

    Real-time web access lets adjusters view all case progress and claims documents as needed

  • Audit Trail

    Each event is tracked within the technology, providing an audit trail to support compliance with regulatory timeframes

  • Adjuster Workflow

    An electronic workflow organizes everything from requests to reviews, and all medical documentation associated with the claim

Bill Intake & Management

When it comes to claims processing, there are many moving parts. Our Document Management service lets you move away from a chaotic and antiquated paper- burdened system so you can organize and handle claims with greater efficiency and control.

  • Full Mailroom/Indexing Capabilities

    Intake and organize all document types from receipt to the final product using state of the art scanning technology

  • Data Capture

    Information is collected through bill and document data capture and visual verification

  • Information Retrieval

    Call out service assists in obtaining missing information without adjuster intervention

  • Full Visibility

    Entire workflow is visible and searchable at all times

  • Automated Routing

    Auto routing of claims documents decreases processing time and expense

  • System Integration

    MedFlow technology seamlessly integrates data and images with your current claims system

Bill Review

Our advanced MedFlow Bill Review Technology seamlessly advances claims data through a series of decision engines producing consistent and accurate results. And in times of intense workloads, AIS helps you meet your turnaround requirements and keep expenses to a minimum.

Adjusters have the convenience of online access to medical bills, records and explanation of reviews in real-time with our MedFlow Adjuster Desktop.

  • Intelligent Claims Processing

    Business logic is automatically applied to processed claims to improve efficiency and focus claims associates’ attention on critical decision making

  • Exception Handling

    Automated flags drive work requiring more specialized review

  • Recommended Reimbursement

    Comparison tools determine the appropriateness of medical fee schedules and benchmark fees

Resolution Support

Communication Support

  • Print & Mail Fulfillment

    All explanation of reimbursement, claim forms and correspondence can be printed and mailed to providers, claimants, and their representatives

  • Call Center

    Our customer service team is on-hand 24/7 to service inquiries in a timely and accurate manner

New Jersey Solutions

Since 2001, AIS has been providing Decision Point Review (DPR)/Pre-Certification and other specialized New Jersey services.

Our experience in the NJ auto insurance market allows us to effectively provide solutions that manage the requirements of the Automobile Insurance Cost Reduction Act of 1998 (AICRA). These solutions can be implemented in any combination as needs change.

  • DPR/Pre-Certification

    Nurse case managers and physician advisors in rendering determinations review treatment requests to substantiate medical necessity according to New Jersey treatment protocols

  • Prospective Case Management

    This approach employs direct contact with all parties at the point of referral and at regular intervals throughout the life of the claim

Reporting & Analytics

  • Provider Activity Reporting

  • Industry Benchmarking

  • Trend Analysis

  • Emerging Risks

We’re ready to help.

AIS

Submit a First Party solution request today.

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