Let Us Fill the Gap

Appeals are yet another area of focus where we can provide independent expertise to fill very important voids in staffing or outsourcing.

Issues We’ve Observed:

  • Misunderstanding of ERISA timeframes
  • Use of same claim team to address appeals
  • Inaccurate or incomplete denial/decisions letters
  • Decisions based on undocumented information
  • Denial or decision letters not in accordance with ERISA
  • No de novo review
  • Not using appeals for training and development

How SALT Can Help:

  • Thorough de novo review of adverse claim decisions
  • Ensuring appeal process remains independent of claim organization
  • Compliance with ERISA timeframes
  • Identifying training and development opportunities
  • Identifying risk management trends
  • Providing feedback to claim organization
  • Conducting full and fair review for claimant to exhaust their administrative remedies
  • Conducting full and fair review for carrier to ensure appropriate decisions are made
  • Educating claimant/customer – ERISA, appeal procedures and next steps if any

Let’s talk about how we can help. Contact us directly about your project. Or, call us toll free: 1-866-846-7258.