Detection Services

Prospective Detection and Investigations identify fraudulent and abusive claims for investigations before the claim is paid. With this service, we can help you achieve savings seven to ten times greater than recovery efforts alone.

Fraud and Abuse Detection services help you:

• Prevent payment on erroneous claims
• Discover potentially fraudulent claims
• Recover overpayment losses

Injury Coverage Coordination

Gives you the unique ability to either fully or partially avoid claim expense by coordinating coverage with workers’ compensation, automobile medical policies, no-fault, or other non-group medical reimbursement systems on accident-related injuries prior to paying the claim.

Retrospective Fraud and Abuse Service

This service includes expert evidence analysis, interviewing, medical records review, and case documentation. For the cases that progress into the recovery stage, an experienced team of professionals then perform a deeper level of investigation, coordinate recovery negotiations, agree upon and arrange settlement agreements, and recover dollars.