4/14/2025 - 0 min read
The Claims Coverage Identifier (CCI) Report will contain the NAIC Number associated with the Insurance Company.
1/3/2025 - 1 min read
We have developed two new reason codes that flag providers who appear on government watchlists and are excluded from participation in government-sponsored programs such as Medicare and Medicaid. Medicaid and Medicare fraud result in nearly $100 billion in losses annually. This potentially includes activities such as billing for unprovided services and…
1/3/2025 - 1 min read
We’re thrilled to introduce a new enhancement to our Pilot Scoring system! Now, customers can easily evaluate claims submitted prior to Pilot Scoring enablement, eliminating the need for extra development resources and resubmission. This feature grants the user greater visibility into past claims. Previously, claims submitted to ClaimSearch before Pilot Scoring activation…
1/3/2025 - 0 min read
The main ClaimSearch Login Page has received a minor update, with changes focused on updated branding and colors. These changes are cosmetic only and will not impact the user’s workflow to login to ClaimSearch or how they use the website. Only those users who login to the website manually with…
12/10/2024 - 1 min read
We have implemented several updates to existing rules while introducing four new ones to efficiently identify prior hail related losses at both the involved party and vehicle levels of granularity. These enhancements are designed to aid investigators in detecting potentially suspicious claims and mitigate risks of hail related fraud Since 2019, approximately…
12/3/2024 - 2 min read
We have implemented several updates to the landing page, modernizing its overall design and functionality. These enhancements include new KPIs, links to intelligence liveboards, and metrics at various levels of granularity, designed to fit varying needs, all aimed at equipping investigators with the tools needed to effectively address provider fraud, waste and…
11/4/2024 - 1 min read
We’ve recently released a new version of our Risk Response integration, designed to provide more detailed information related to ClaimAlerts and Claim Scoring rules activity in your claim. With this new version, your system and users can be more efficient, acting on the output we send you. Additions in this version include...