ISO Claims Partners provides Medicare compliance and claims resolution services to many of the largest property/casualty insurance companies, as well as self-insured companies and third-party administrators. The services help our clients meet their obligations under state and federal laws — while also reducing claim costs, expediting settlements, and improving efficiency.
We provide tools to help you with:
We also provide protocol design and settlement consultation services to help your organization resolve claims quickly and efficiently.
ISO Claims Partners
400 Riverpark Drive, Suite 400
North Reading, MA 01864
The only predictive analytics solution to incorporate industry data. WC Navigator® predicts claims severity throughout the life of a claim to inform your claims process and improve outcomes.
A comprehensive analytics solution that enables claims handlers to apply best practices in the investigation and resolution of liability and injury claims. Liability NavigatorTM assists with determining liability, identifying subrogation recovery opportunities, and properly evaluating and negotiating claims while improving claims handling consistency.
Case in Point
The newest enhancement to the Navigator platform provides adjusters with vital claims intelligence and decision support to improve insight at critical points in the claim life cycle. Case in Point delivers an instantaneous analysis of claim attributes from historical information.
The most cost-effective and streamlined way to handle Medicare conditional payments
Conditional Payment Services
Investigation, consultation, and compliance services to help you challenge and reduce Medicare's demands for reimbursement of conditional payment claims
comprehensive Section 111 reporting tool with integrated conditional payment and Medicare Set Aside guidance
MMSEA Section 111 Compliance Audit
A review of your Section 111 reporting process — to help you avoid penalties, improve workflow, and reduce loss costs
An analysis of the potential amount of the Medicare Set-Aside for a claim — to help you determine if settlement of the case is feasible
An analysis of the potential amount of the Medicare Set-Aside for a claim, together with an assessment of the prescription medications involved — to help you determine if settlement of the case is feasible and proactively address the cost drivers
A medical and legal approach to help you comply with Medicare requirements, regardless of the type and size of your settlement
Medical Cost Projection
A forecast of reasonable and likely future medical costs for an individual claim to help you set reserves and proactively plan for settlement
Services — based on legal advocacy — to help you reduce the cost of Medicare Set-Asides to $0 in appropriate cases
A plan to ensure compliance, control costs, and cover future medical costs when a beneficiary receives a settlement that does not meet MSA review guidelines
MSA Clinical Review
An analysis of the pharmaceutical costs associated with a Medicare Set-Aside
Protocol Design Service
Help with designing your own procedures for complying with Section 111 reporting, conditional payments, and Medicare Set-Aside requirements
Settlement Consultation Services
A consultative approach to drive settlements quickly and cost-effectively