Claims Intake Lifecycle Process

NetClaim sets the standard for reliable reporting of complex information. Our state-of-the-art data synchronization and location services give you efficient, precise claim reporting. All day, every day.

Precise Intake

NetClaim dynamically adapts intake scripts and prompts our intake specialists to provide information that may be missing. This intelligent process ensures accuracy while allowing the intake specialist to focus on the caller.

Seamless Referrals

We integrate your referral network with our reporting system to generate an appropriate referral. Best of all, we refer to all major Preferred Provider Organizations (PPOs). No matter which network your customer utilizes, or how often they change, NetClaim can handle the transition seamlessly. We can also help guide employees to other referral partners, like auto repair shops, to make the reporting process the first step in managing claims.

Automated Integrity Checks

Before a call is complete, NetClaim conducts real-time quality assurance through automated integrity checks. The system flags potential inconsistencies or missing information and allows the intake specialist to verify information with the caller. It’s like having a second intake specialist on every call who is focused on remembering the details.

Efficient Dissemination

Once claim information is gathered and accurately documented, we ensure it is delivered to the correct destination. Our reliable notification system is guided by customer-specific business rules, enabling us to trigger dissemination with exceptional speed and accuracy. Reports can be disseminated based on any question in the script and can be sent via email, fax, or in a variety of EDI formats.

Quality Review

In some cases, incidents go through a second quality review. Our quality review process occurs after the initial interview and re-ensures the accuracy and appropriate completion of the incident.

Automated Escalation

When a critical call comes in, you need to know immediately. Our powerful rules engine ensures we follow your escalation requirements, no matter how complex. The notification process can be tailored to the day of the week, the location involved, the type of incident or any other aspect of the report