Our workers’ compensation third-party administration (TPA) programs are designed to deliver quality care for injured employees while controlling claim costs and minimizing employer risk. Leveraging technology, local expertise, and customized workflows, these programs create better outcomes for businesses and employees. Dedicated teams collaborate closely with employers to create customized strategies that support employee recovery, maintain regulatory compliance, and drive business efficiency.
Immediate access to 24/7 nurse triage services ensures a quick response at the time of First Notice of Loss (FNOL). Our multilingual team initiates claims promptly and guides employees through the appropriate care path, setting the tone for faster recovery and better outcomes.
Integrated managed care services include nurse case management, medical bill review, preferred provider network (PPO) access, and utilization review. These solutions work together to deliver high-quality medical care, accelerate return-to-work timelines, control medical expenses, and ensure compliance with regulatory and Medicare requirements.
Comprehensive Medicare compliance solutions help protect against regulatory exposure and ensure proper handling of claims involving Medicare beneficiaries. Through partnerships with industry-leading providers, services such as Medicare Set-Asides (MSAs), conditional payment resolution, and Section 111 reporting are seamlessly integrated into the claims process, supporting full regulatory adherence and reducing risk.
Comprehensive Special Investigative Unit (SIU) solutions help strengthen fraud prevention efforts and support appropriate claim outcomes. Delivered through trusted investigative partners, services such as field investigations, surveillance, and background checks are seamlessly integrated into the claims process. This approach ensures data continuity, enhances reporting and analytics, and contributes to more timely claim resolution and cost containment.
Financial stewardship is a core priority throughout the life of a claim. Treasury management services include establishing accurate reserves, processing timely payments, and employing multi-layered security protocols to safeguard all financial transactions and data, helping ensure transparency, compliance, and trust.
Clients have 24/7 access to a secure online portal, providing real-time visibility into claims activity, customized dashboards, benchmarking, and detailed claim data. Stewardship reports offer clear insights into program performance, while full support for regulatory and Medicare compliance ensures transparency and protection throughout the claims lifecycle. Proactive analytics empower employers to make critical decisions that drive improved outcomes and lower risk.
Programs are customized to meet each client’s unique service instructions, workflows, and goals. Through local service delivery, tailored solutions, and a strong focus on stewardship, these services protect businesses, support injured employees, and drive measurable improvements across workers’ compensation programs.
Reporting & Analytics
Our online claims portal delivers a clear view of critical claim data, offering customized dashboards, benchmarking, ad-hoc reporting, and detailed analytics. Proactive data mining empowers better decision-making, helping reduce risk, enhance service delivery, and improve your bottom line.
Client-Centric Solutions
Client-centric solutions focus on faster return-to-work, reducing claim costs, lowering medical spend, and integrating across business lines. Every program is tailored to align with your goals, supporting both employee recovery and business performance.
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