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Concerned how your claims are being handled by your TPA?

claim handling

The proper handling of workers' compensation, general liability, and transportation claims can be an ongoing concern for organizations.

Our Claim Handling and Investigation Analysis Program is an independent review of the performance of your TPA. We will analyze if claims have been handled properly and if compensibility determination was properly investigated before making claim payments, if the payments made were accurate, and if the workers’ compensation injuries claimed were causally related to the work accident.

We provide a comprehensive review of:

  • Compliance with the carrier

  • Industry Best Practices

  • Special Handling Instructions

  • SLA Performance

  • Reserve Setting

  • TPA Performance

These areas are reviewed to analyze if the TPA has complied with their contractual obligations and if best practices are being followed in specific areas.

The findings of our review are documented in a detailed report consisting of our observations, recommendations and identify areas of improvement.  The report also includes a data sheet reflecting areas of where potential savings and improved outcomes can be found which include:

  • Precise analytics

  • Reserves

  • Expenses - legal, medical, IA

  • Initial handling timeliness

  • Plan of action execution

  • Investigation quality check

  • Lag time

  • Subrogation opportunities

Upon completion of our detailed report, we submit a copy for your review and schedule a meeting to review the report in detail with the appropriate staff from your organization.

claim handling
Need more information? Schedule a short, no-cost consultation with a Veritas Claims Supervisor!
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