Our Audit, Data Mining, and Recovery Services
SCIOinspire's highly customized client solutions are built on our constantly improving technology platforms; our in-house clinical, legal, and analytical expertise; and our ability to work closely with you to create a solution that makes sense for your business. We offer our clients speedy deployment and flexible pricing models, and our web-based reporting capabilities mean you'll always know where you stand. In addition to custom solutions, our industry-leading subrogation and coordination of benefits solution portfolio includes:
- Subrogation Recovery – Boost your recovery rates with our state-of-the-art subrogation platform, web reporting, and in-house expertise.
- Coordination of Benefits - Know who owes what and which third party is liable for what portion of claims with our COB pre-payment and post-payment solutions.
- Fraud Detection & Prevention – Identify patterns to plug the leaks and prevent them in the future.
- Specialty Audits – We'll help you get real answers to your most nagging questions.
Client Pain Points
- Third party liability such as subrogation with auto, workers compensation and product liability can be as much as 1% to 1.5% of total claims costs
- Coordination of benefits with other carriers based on eligibility can cost as much as 2% to 4% of total claims costs.
- Overpayments of over $100 billion annually in healthcare industry
- Difficulty in linking drug and medical claims to get a full picture of a claim
- High-cost, time-consuming solutions without well-defined technology or workflow processes
- Lack of expertise to properly evaluate overpayments and third-party liabilities
- Lack of transparent and flexible outsourcing models
- Weak reporting
Our Value Proposition
With our unique combination of analytical tools, auditing skills, and healthcare expertise, SCIOinspire will find not just the large third party liabilities, but also the small ones that add up quickly. Our skilled specialists (including legal experts, pharmacists, physicians, claims analysts, technology experts, and business consultants) know what to look for and how to solve the problem. Our flexible and transparent service delivery model produces a highly customized solution that will deliver much-needed recovered dollars. Partnering with SCIOinspire will help your organization:
- Increase recovery dollars through better identification and investigation techniques
- Get higher settlement ratios for subrogation-related claims
- Increased claim savings through integrated delivery models such as identifying third party liability claims before payment where possible and recovering paid dollars when required.
- Coordinate benefits more efficiently
- Prevent fraudulent claims
- Eliminate overpayments
- Stay informed with web-based reporting
