Claim Audit

Claim audits are an important part of a claims department. Making sure standards are being met by the carrier, TPA or in-house adjusters is critical to cost containment.

Our Claim Audit module allows you to retain the result of each audit conducted so that you can see how well your claims are being handled. You can historically look for claim handling performance changes good or bad.

  • Contact Frequency
  • Investigations
  • Subrogation
  • Cost Containment
  • Return to Work
  • Reserving
  • Action Plans
  • Communication
  • Notes & Document Attachment

Our Design

Many times it can be problematic to be able to integrate claim audit reviews with a good RMIS system. At INFORM we decided to make that integration happen. We designed our Claim Audit module so that it could either work alone or work side by side with our Claim Intake and RMIS systems.

We've got you covered! We have many of the typical questions asked during claim audit reviews. In addition, we designed the database so that we could create the evaluative reports needed to see how you claims are being handled by each adjuster involved with the review. Further, since we store each audit result you can look back historically for improvements in claim handling performance.

Why choose us?

1

Designed for claim adjustersEvaluate key components for claim reviews

2

Excellent report packageComparative and evaluative performance reports