CLAIMS MANAGEMENT

American All-Risk Loss Administrators has developed effective claims management processes to ensure that all potential claims issues are promptly identified. All claims are reported through our Fast Track/Intake Department to ensure early identification of:

· Insurance Coverage · Return-to-Work options
· Compensability AOE/COE issues · Medical Control
· Fraud · Claims Reserving
· Third Party Subrogation Recovery · Appointment of Permanent Disability to Non-   Industrial Factors or Prior Disability
· Litigation Potential  

This allows less technical claims to be easily handled within the Fast Track Department and more complicated cases to be assigned to our technical claims examiners.

Our highly trained, experienced professional Claims Examiner staff have backgrounds in almost every type of workers' compensation environment, which include:

· Large Corporations · Self-insured Public Entities
· Small Businesses
· Self Insured Private Employers
· Employers with Multiple Locations  

AARLA can customize its services to suit the claims reporting and handling requirements of any specific client. Our courteous, professional staff is available to help you manage the cost of your workers' compensation claims by providing transitional or modified return-to-work solutions which assist in keeping lost time to a minimum. Our claims professionals are also able to assist in providing you with information through a variety of sources, including loss run reports, claims reviews, and educational materials and seminars for your employees and management staff that can help contribute to a safe working environment, and to a better understanding of the status of current open claims.

AARLA strives for excellence in its adherence to well-defined standards of effective claims handling, in tenacious pursuit of two objectives: (1) Responsible and timely administration of benefits in compliance with the law, and (2) Excellence in claims handling, including intelligent claims investigation that identifies questionable claims, and prudent cost containment practices that allow greater medical control and reduction in claims cost.

AARLA also utilizes a panel of experienced outside vendors to provide ancillary services that also can contribute to superior claims result. This panel includes:

· Workers' Compensation defense attorneys
· Field Investigators
· SIU Fraud Investigators
· Vocational Rehabilitation Vendors

Through our affiliated company, Total Managed Care, Inc. (TMC), we have developed one of the most extensive medical networks available today. Our preferred providers offer a complete range of medical services such as:

Physicians in every medical specialty Durable Medical Equipment providers
Hospitals and Clinics On-site Nurse Case Managers
Pharmacy Benefit Program Language Interpreters
Surgical Facilities Medical Transportation Vendors

As an extension of these services, AARLA and TMC also offer on staff Nurse Case managers to provide telephonic case management, utilization review, a Return-to-Work Coordinator and Medical Bill Review services to guarantee compliance with California's Official Medical Fee Schedule. For more information, visit the TMC web site.

AARLA also manages medical costs by the use of a Medical Provider Network, furnishing employees with access to appropriate, quality medical providers; while additionally helping to contain medical costs by keeping all medical treatment within the network.

 
© 2007, AARLA
All Rights Reserved
PO BOX 9783
Fresno, CA 93794
Phone : 559-277-4960
Fax : 559-277-4961