Auditing & Consulting Services

Claim Management Consulting

inHEALTH provides consulting services to enhance injury claim management. With over 35 years of strategic and operational experience, our experts offer objective insight, innovative and efficient solutions, and value added services. Partner with inHEALTH consultants for short or long-term engagements.

 

Services include:

  • Business model architecture and best-practice methodologies
    • Supported by proprietary claim management and data analysis tools
  • Driving best-practices from analytics
  • Workplace shadowing
  • Onsite resources for direct support
  • HCAI best-practice resource management

 

Medical Management:

  • High-risk MIG claims
    • Best-practice development
    • Claim complexity scorecard for claim assignments
  • Serious injury and catastrophic claims
  • Negotiation, mediation, and settlement consulting

 

Vendor Management

inHEALTH’s experts apply their experience and insight to comprehensive vendor management. We offer a range of services from vendor selection to auditing and performance management.

 

Services Include:

  • Vendor selection and negotiating vendor agreements
  • IE audits
  • Litigation audits
  • Customized performance management of vendor programs complete with audit reports and recommendations

Audit, Compliance, and Quality Assurance Reviews

The elements of a successful insurance organization – customer service, expedient claim processing, and cost efficiency – all depend on the quality and consistency of your data and resources. inHEALTH’s audit, compliance, and quality assurance reviews ensure that your business practices not only meet legislative and regulatory guidelines, but are consistent and efficient. Our external, recommendation-based auditing services can help you meet compliance requirements and identify opportunity areas.

 

Services include:

  • Retrospective and concurrent file review audit
  • Reserve accuracy
  • Minor injury tracking and containment analysis
  • Service provider tracking and reviews
  • Regulatory compliance reviews
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