We eliminate the need of relying on plan members by utilizing proprietary software to submit our pre-screened subset of “potential” claims to ISO, a national database of all property and casualty claims.  If a plan member has filed a claim against any party, we’ll know about it.  Our capability enables us to go directly to the first or third party recovery source to assert our client’s subrogation claim. This approach offers us a distinct advantage, benefiting our health plan clients through maximum case identification and recovered dollars.

By reviewing ICD-9, CPT, and DRG codes, and utilizing episodic treatment group software, we create an accurate subset of claim data to be matched against the national ISO database, comprised of all casualty claims in the country.  If your member has filed a claim against any party, we’ll know about it, regardless of whether they’ve hired an attorney or even filed suit.  You can even review report results before we initiate recovery efforts.

Our systems work with any claim system and data format.  We provide data specifications, but can also work with existing interchanges or extracts.   Back