Information for Claim ProfessionalsInformation for Claim Professionals

Auto Injury Solutions is a national company led by medical and automobile insurance claims professionals who bring significant experience to the products and services. Our focus is on providing customizable, end-to-end medical review solutions to clients in the Property & Casualty Insurance Industry (PCII) through our integrated technology and outsourcing product suites.

Auto Injury Solutions’ integrated approach eliminates the burden of using multiple vendors during the life cycle of a claim. We have found that fragmentation can be a drain on insurance carrier resources attempting to synthesize the results of various functions into their final determination of a payment on a claim. Outcomes and processes can be inconsistent. Auto Injury Solutions’ flow-through technology, coupled with our professional services, provide value to the insurance carrier by producing consistent and defensible results while eliminating the time and cost associated with coordinating multiple functions.

We have invested heavily in becoming process experts and delivering strong medical/technical expertise to the management of medical claims, providing the synergy of an integrated and monitored approach guided by a strong understanding of each jurisdiction’s underlying rules.

We deliver our services with the support of a strong workflow management system that was internally developed with five goals:

  1. Rules-based document management workflow allowing medical bills and documents requiring professional review (certified professional coders, nurses, physicians) to be automatically routed to the appropriate professional.
  2. Automation of claims administration processes that allows the carrier to shed many of the reimbursement-related functions from the adjuster tasks to lower costs and increase consistency.
  3. Measure compliance to best practice on every task.
  4. Access by our 24/7 customer service group to real-time information on the status of any medical bill to better service the provider inquiries and remove that burden from the adjuster.
  5. Web access for the adjuster to our electronic medical file (bills, EORs, notes, police reports, requests for documentation, etc.), which includes multiple search functionality as well as real-time communication between the adjuster and Auto Injury Solutions.

Auto Injury Solutions offers an integrated solution for “life of a claim” first- and third-party claims processing including:

  • Mailroom – High-speed imaging of inbound documents and/or outbound document handling
  • Document Management – Web-based presentation layer to adjusters with adjudication functionality
  • Bill Review – State-of-the-art medical bill audit
  • Utilization Review – Statutory pre-certification requirements (e.g., New Jersey)
  • Nurse Review – On-staff nurses
  • Code Review – Certified professional coders review bills
  • Evaluative Services – Medical professionals on staff and access to a nationwide panel
  • Dispute Resolution – Support for litigation and arbitration
  • 24/7 Customer Service – Call center located in Springfield, Massachusetts
  • Demand Package Reviews – Third-party audit and analysis with bill review and professional analysis with narrative
  • Consulting – Claim review processes, SIU initiatives, and medical management workflow analysis

You will find that our service, technology, and ability to customize will result in consistent, accurate, and equitable outcomes for your insured as well as increased productivity in the processing of your claims. We are committed to providing your organization with best-in-class solutions to your medical automobile claim needs.

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AIS is an equal opportunity employer.