Technology

You can be Completely Safe in this Recent Era of Technology where Frauds have made People Afraid of Everything with the Help of ISO ClaimSearch

ISO ClaimSearch is a system for insurance fraud detection which is owned by the Insurance Services Office which is a specific organization in the U.S. Being one of the largest private databases in the world, it contains detailed records of losses paid from participating insurers and insurance premiums collected. ISO database is actually more than just the world’s largest database of causality or property claims, it is also a claims intelligence platform that is very robust. 

An essential step that is one of the first steps in fraud detection is its claim-matching technology and the results can facilitate fast-tracking. Seamless access which integrates claims-fraud detection and investigative analysis tools is also provided in the platform. It is quite a feat that more than 90% of the casualty or property insurance industry relies on ISO ClaimSearch. You can contact the NICB at 1-800-447-6282 to request ISO ClaimSearch authorization.

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Features of ISO ClaimSearch

  • Decision Net

You can get missing details to complete claims and also find the critical data you need at FNOL which can help to complete claims quickly and spot potential fraud. Mainly, Decision Net helps to fill in the gaps with supplemental claims information from the sources which are some of the best ones out there. This is a huge help for claims teams to improve expedite meritorious claims, decision making, and also increase the impact of SIU referrals. 

You can learn how the decision net helps the claim handlers to access missing information quickly to process the claims faster and also improve investigations. The decision net is seamlessly integrated with ISO ClaimSearch, hence adjusters can also save a lot of time by accessing vital information within one single platform instead of searching for several sources. 

  • ISO MedSentry

You can protect yourself with the help of this feature where their predictive analytics stop and predict healthcare waste, fraud, and abuse. It applies advanced analytics to the medical bills while also providing a risk score for every medical provider in the book of business you can have. 

After that, it produces a report which has all the details of the specific issues in your billing data as well as clinical analysis which describes what to investigate and also the suspect behavior. It helps to take decisive action against suspicious medical providers, process legitimate medical bills quickly, prioritize exposure associated with medical providers and also analyze injury claims more accurately.

  • ClaimDirector

This feature helps to detect claims frauds as quickly and accurately as possible with predictive analytics. Since, the insurers need to determine and efficiently whether a claim would be fraudulent or not, or if it can be fast-tracked for settlement. This feature uses the power of predictive analytics to score claims with better accuracy and also reveal questionable attributes. 

ClaimDirector Architect can help you to build fraud, custom rule scenarios, and this is an add-on to ClaimDirector. You can also test ideas in a sandbox environment by using ClaimDirector business rules and also other points of data for flexible claims fraud detection which is also more efficient. It allows you to respond quickly to emerging trends, create targeted alerts for your modeling, and also collaborate internally with data scientists in order to optimize the scoring process.

  • CaseManager

You can improve investigation case management and also eliminate inefficiencies with its help. This is a fully configurable fraud management solution that improves productivity as well as efficiency by automating assignment, triage, and compliance reporting. 

It can conform to whatever workflow you need even if it is for managing multi-jurisdiction or complex case investigations. The digital Kanban tool and the solution’s modern interface make it easy to prioritize and manage your work. Moreover, it is a SaaS platform that has minimal IT lift. 

  • NetMap

According to the Coalition Against Insurance Fraud 61% of the insurers say that organized fraud is increasing. You can fight organized insurance fraud with advanced link analysis with the help of this feature. It helps to identify organized insurance frauds by discovering hidden connections among businesses, claimants, and providers. 

The advanced analytics greatly enhance the SIU’s ability to discover all the fraud rings which are present within the company’s claims least. Most importantly, the software also quickly evaluates public data, claim information, and also other details or data to reveal patterns that are indicated of the frauds.NetMap has been used by many people, so they uncovered a staged auto accident ring that involves 250+ claims at 12 insurance carriers.

Conclusion 

We wish for you to not get fooled or scammed by any type of fraud. We hope this article will give you all the necessary details to not get into trouble during the first few days while using ISO ClaimSearch.