From strategy through process – consistently high quality through flawless execution
Achieving highly efficient and effective process performance in the insurance business is all about mastering the many detailed requirements. Because of our extensive operational expertise and broad process knowledge, TriPlus understands how to accurately assess current performance in claim management, administration, and payment.
More importantly, our multi-phased process audit program results in specific and actionable recommendations for improving performance, increasing compliance, and reducing risk, based on proven techniques and extensive industry specific knowledge. The focus is on performance measurement and quality assurance and it involves:
- Correspondence and documentation
- Clinical practice
- Claim adjudication and management
- Regulatory compliance
- Fraud detection
- Legal risk exposure
- Best practice adoption
The keys to our approach:
- Proven Strategies for Performance Improvement: Because of our experience and track record in administration and process management, we can provide the insights and best practices to boost process efficiency and compliance, while reducing administrative fees and expenses.
- Multi-Disciplinary Team: Beyond claims and other core processes, we have experts in legal, compliance, actuarial and finance to assess performance and ensure solutions are effective on multiple dimensions.
- Regulatory Knowledge: We have a deep understanding of the requirements of the jurisdictions concerning regulations and related interpretations.
- Integrated Technology and Quality Data: Our scalable and customizable platform integrates voice, image and data – meaning higher quality policy and performance data is available to serve claimants in a superior manner with greater accuracy, speed and consistency.