Claims Management and Fraud Prevention

Our comprehensive suite of tools supports you at every step of the claims life cycle — from claims reporting and analysis through claims adjustment and investigations. Our tools, software, and analytics help you streamline your workflow, control costs, and fight fraud.

We created the industry’s premier claims reporting and management system, along with complementary databases, to help you quickly identify meritorious claims for processing. We offer a variety of tools to help detect and prevent fraud, including software that uses visual link-analysis technology to uncover suspicious patterns that would otherwise go undetected.

Our specialized tools help you streamline the subrogation process; manage complex bodily injury, workers compensation, and comparative liability claims; and automate SIU case management. We even help you estimate repair costs for structural repairs and personal property.

We provide services and national databases to prevent cargo and heavy equipment theft and improve recovery rates. And our background checks and employee screening services help you mitigate risk, protect your assets, and remain compliant by maintaining rigorous hiring practices.

 

Products and Services

Protocol Design Service Developing a Medicare game plan Medicare Secondary Payer (MSP) compliance continues to present challenges for claims payers. You need a game plan from day one. Recognizing how to navigate the major MSP issues affecting claims should be an integral part of any effective claims-handling practice. The ISO…
MMSEA Section 111 Compliance Audit An MMSEA Section 111 Compliance Audit from ISO Claims Partners is a detailed review of your Section 111 reporting process. Such an audit can help you avoid penalties, improve your workflow, and reduce loss costs. Background Section 111 of the Medicare, Medicaid and SCHIP Extension…
MSP Navigator The leader in Section 111 reporting MSP NavigatorTM from ISO Claims Partners is a comprehensive Medicare Secondary Payer Act compliance toolbox. In service since the Centers for Medicare and Medicaid Services (CMS) began accepting data in late 2009, MSP Navigator is the premier reporting tool. The service addresses…
Conditional Payment Services Pay what you owe and nothing more ISO Claims Partners Conditional Payment Services consist of investigation, consultation, and compliance services that can help you challenge and reduce Medicare's "liens" — or demands for reimbursement of conditional payments. The services can help make sure you pay what you…
CP Link Streamlining the conditional payment process and reducing costs CP Link from ISO Claims Partners is a cost-effective and streamlined way to handle Medicare conditional payments. The service uses Section 111 data to drive the conditional payment process automatically and assure correct, consistent handling every time. CP Link helps…
Technical Advisory Services from ISO ISO provides technical information to serve the needs of loss control, premium audit, and catastrophe claims management. ISO's Engineering & Safety Service (E&STM) is the insurance industry's primary source for information on loss control. E&S provides technical reports, legislative and regulatory information, consultation, and educational…