Identifying any recovery opportunity begins with claim data.  We scrub data using a developed set of procedure codes (ICD-9, CPT, DRG), and episodic treatment group software, to indicate the broadest subset of claims that may have been the result of an accident.  We then perform levels of investigation to determine further recovery viability.

The traditional method of investigation involves sending accident questionnaires to plan members whose claims have been identified as having recovery potential.  However, this approach is not wholly reliable because it relies on plan member cooperation and truthfulness, and often requires claim payor follow up. We utilize a much better method.

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