INETICO Care & Claims Management Services

Recovery &
Legal Services

Savings Optimization
and Stabilization

Prospective integration of claims and utilization review processes and retrospective data mining yields significant return on investment when early intervention is initiated by our experienced legal team.

Experience Legal Team

What’s Inside the Box

Subrogation & Recovery

  • Pre-Claim Possible Subrogation opportunities are identified during precertification process. Maximizes the plan’s cost savings before member engages an attorney

  • Post-Claim Subrogation and Recovery through claim file analysis

  • S.O.S. - Savings Optimization & Stabilization INETICO's legal team data mines your retrospective claims to ensure funds due the plan from a third-party are captured

Experience Quality

Legal Services

  • Legal support to client relative to payment disputes
  • Legal support to client for their employees on "balance billed" and collection notices
  • Claim determination reviews relative to plan document wording and stop loss policy wording
  • Review hospital bills for overbilling & fraudulent services
  • A "high level" audit on out of network bills with legal support for a steeper discount

The INETICO Advantage

  • Early identification of third party liability claims resulting from precertification process
  • Increased reimbursements when recovery of funds is captured prior to member engagement of an attorney
  • Pre-claim intervention maximizes plan savings
  • Experienced legal team data mines retrospective claims each week
  • Ensures funds due to the plan by a third party are captured

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