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 ServiceDeveloping a Medicare game planMedicare 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 Claims Partners…
MMSEA Section 111 Compliance AuditAn 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.BackgroundSection 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007…
MSP Navigator®Proactive, accurate, claims complianceEliminate the guesswork and compliance gaps from your Section 111 reporting with MSP Navigator®. As the premier Section 111 reporting tool, MSP Navigator proactively handles compliance in a way that:considers your organization’s systems and claim-handling proceduresminimizes intrusion into adjuster time and workflowsaves time while ensuring error-free…
Conditional PaymentsGain a strong advocate in Medicare disputes to eliminate risk and exposureThe stakes are high when dealing with Medicare conditional payments. With the right advocate, you can save money, mitigate exposure, and ensure resolution of claims. As an industry leader, ISO Claims Partners is uniquely positioned to ensure proper…
CP Link™The only automated and integrated solution to expedite conditional payments and improve your compliance programWith Section 111 reporting, you’re already sending Medicare all the data it needs to seek recovery on conditional payments. Now you can put that same data to work for you. Addressing Medicare exposure programmatically and…
XactAnalysis®Analytical and reporting tools for claims, underwriting, and service providersXactAnalysis®, from ISO’s sister company Xactware, is a powerful set of analytical and reporting tools for insurance claims and underwriting departments. Contractors, independent claims adjusters, and other service providers can also benefit from integrating XactAnalysis into their workflow.The XactAnalysis networkThe XactAnalysis…