Let’s Take a Look Under the Hood
Every organization has an internal quality review or audit function. However, it can be difficult to “self-evaluate” in the typical busy, high intensity claim operation environment. You may need a different perspective – one from an objective industry expert like SALT.
Who Is a Typical Customer?
- Disability, Life or LTC insurance carriers who need their claim practices and risks assessed
- Reinsurance companies who involve us in working with their customers
- Employers interested in their claim administrators’ performance
- Brokers and consultants wanting independent expertise for their customers
- Third-party administrators who may want an assessment of a new block of takeover claims
How Does It Work?
Having worked for and managed claim organizations, we understand what it’s like to have outsiders on the floor. We work hard to collaborate with our clients to make sure the engagement is swift, positive and productive.
Claim audits vary by project; however, typical examples of the discovery process include:
- Finding consistency in following the prescribed workflow
- Evaluation of staffing, caseloads, and caseload characteristics
- Calculating timeliness of actions
- Looking for appropriate claim file documentation
- Use of risk management tools and techniques
- Examination of STD to LTD transition
- Analysis of communications
- Assessment of telephone use
- Change in definition
We’d like to be part of your team! Contact us directly or call us toll free: 1-866-846-7258.
The SALT Methodology
For over 15 years we’ve been studying the Disability and Life insurance industry. In fact, we’ve performed over 100 claim audits or operational analysis in over 35 different claim organizations. We have designed a methodology, assembled an expert staff, and built technology around a process that provides consistent results and effective solutions.
Our proven methodology is highlighted by use of claim data, our proprietary audit tool, SaltGear, expert claim team, and the claim sample selection process.
The data analysis includes an integrity check (scrubbing), segmentation, prioritization, and a recommended set of criteria from which to select claims for the audit. The claim selection criteria expose themselves after careful review of red flags and trends discovered during this analysis.
We’re able to uncover opportunities for improvement, as well as validate an organization’s assumptions. Through the claim data analysis alone, we typically uncover savings that more than pay for our engagement.
Our Clients Receive:
- A data analysis report
- Recommendations and possible claim strategies
- A report package from SaltGear
- Copies of claim file plans for each claim reviewed