No two claims, or insurance operations, are exactly the same. That’s why we design fully customizable and comprehensive 1st party solutions that streamline the entire claims process and eliminate the burden and expense of using multiple vendors.
Our solutions can be bundled or used individually—allowing you to select and deploy the right combination of our products to meet the unique demands of your business. Choose AIS and you'll always have the right tools to provide the best service:
By utilizing a single provider, synthesizing results becomes a much quicker process
Our state-of-the-art medical bill audit produces consistently accurate information
The automation of administrative processes reduces adjusters’ more cumbersome tasks
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.
Real-time web access lets adjusters view all case progress and claims documents as needed
Each event is tracked within the technology, providing an audit trail to support compliance with regulatory timeframes
An electronic workflow organizes everything from requests to reviews, and all medical documentation associated with the claim
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.
Intake and organize all document types from receipt to the final product using state of the art scanning technology
Information is collected through bill and document data capture and visual verification
Call out service assists in obtaining missing information without adjuster intervention
Entire workflow is visible and searchable at all times
Auto routing of claims documents decreases processing time and expense
MedFlow technology seamlessly integrates data and images with your current claims system
Our advanced MedFlow Bill Review Technology seamlessly advances claims data utilizing analytical tools to produce 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.
Business logic is applied to processed claims to improve efficiency and focus claims associates’ attention on critical decision making
Flags drive work requiring more specialized review
Comparison tools determine the appropriateness of medical fee schedules and benchmark fees
In cases that require specialized review, files are electronically routed to the appropriate professional, to help you better understand your claims and lower your risk of errors.
With the number of injury codes dramatically increasing, our certified professional coders will determine the appropriateness of the billed procedures based upon AMA guidelines
Physicians are Board-certified, credentialed, and cover all specialties
Our on-staff nurses will help you understand the injuries and treatment in question
Services, procedures, and medications administered and billed appropriately
Highly skilled negotiators help reduce out-of-network healthcare expenses
We’re here to answer billing inquiries, investigate issues, and support insurers and their defense counsel in resolving disputes
All explanation of reimbursement, claim forms and correspondence can be printed and mailed to providers, claimants, and their representatives
Our customer service team is on-hand 24/7 to service inquiries in a timely and accurate manner
AIS offers a national network of PPOs with direct, auto insurance-specific contracts. Clients can design unique network configurations for each state including:
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.
Nurse case managers and physician advisors in rendering determinations review treatment requests to substantiate medical necessity according to New Jersey treatment protocols
This approach employs direct contact with all parties at the point of referral and at regular intervals throughout the life of the claim
Submit a First Party solution request today.