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Audits of specific excess claims can either be accomplished on-site, at the TPA's or carrier's facility, or sent to our offices to be reviewed by our Medical Excess Facility claim staff. We are capable of completing detailed line-item re-adjudications, if requested, reconciling the adjudication made against the Plan Document, the excess policy, or the reinsurance agreement. We make our recommendation to our client, who can be the MGU, the carrier, the reinsurer, or the Lloyd's Syndicate, and often act on their behalf in this capacity, being invisible to the TPA, if necessary. Our staff of claims professionals, based on many years of industry experience and using our sophisticated claim sampling technique, help clients assess the accuracy, efficiency, and timeliness of the work performed by claim paying entities. This includes first dollar and self-funded programs as well as excess loss. Stephen V. Murphy 
Danvers, MA 01923 978.745.6655 smurphy@niis.com |
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