The Audit Group, Inc. : Overpayment & Workers Comp

Arbitration Claims

TAG has evolved its process to include the auditing of files closed by a client's arbitration review team without recovery. It is not uncommon for TAG to see potential recovery from a third party carrier where once there was none.

Custom Remit & Reporting Options

TAG's proprietary software and operating platform allows for the issuance of customized Ad-Hoc reporting options on both remittances and standard calendar reporting. TAG's internal technical team will adapt its system to the needs of its clients on an issue by issue basis.

TAG is currently providing remittance to our clients in several fashions. Let us know if you have specific requirements for remittance, as TAG is equipped to accommodate.

Double Indemnity

TAG is very adept at the potentially delicate auditing of claims in which the client insured received multiple payments on the same loss. "Double Dip" verification and recovery must be handled with the understanding that the party who has been received duplicate payments from a collateral source may still be a premium paying customer of the client, or still has the potential of returning to the clients pool of paying customers.

Internal & Remote Audit Solutions

TAG will travel to a designated location to conduct facility based claims audits with a minimum amount of interference with the daily workflow of its client. Basic workstation access and Internet availability are all that is needed. TAG also has the ability to electronically interface with claims systems in order to facilitate remote audit solutions. By remote accessing clients claim systems, TAG can effectuate the efficient, organized and confidential claims audits with absolutely no interference with the workflow of the client's location.

Missed Opportunity

TAG will audit claims from their original intake to the moment of final closure for missed opportunities in the recovery process. Proper review of available documents and adjuster note histories frequently results in the discovery of information vital to a successful recovery, from both adverse carriers and uninsured parties.

Overpayment & Workers Comp

TAG will proceed with the utmost professionalism and caution when auditing and strategizing the recovery of insured overpayment and Worker's Compensation claims. The creation of a sound recovery strategy from the onset of the audit process allows for a streamlined transition when the claim is actually forward to the designated recovery vendor.

PIP-Med Pay

TAG will review closed claims for subrogation opportunities on PIP-Med Pay claims that were closed by a client prematurely. Due to potentially lengthy treatment periods, a definitive amount for subrogation may not materialize until well after a loss date. TAG can efficiently review claims for potential demands that were never made.

Vendor Overpayments

TAG has reviewed numerous claims where a vendor providing services on a claim is either paid in error, overpaid or receives duplicate payments on the same invoice. Navigating the accounts receivable/payable processes of both small businesses such as local body shops to nationally recognized health care providers can be a time consuming and complicated process. TAG has the ability to recognize these overpayment errors and map out claim specific recovery strategies, without alienating a potentially important service provider.