Lakewood Ranch, FL – Care Bridge International recently announced its actuarial endorsement for accuracy in projecting the medical portion of workers’ compensation claims. Following the completion of an actuarial review in November 2017, prepared by Deborah L Stone, FCAS, MAAA of Stone Business & Risk Consulting, LLC, the company is proud to announce that its processes, models and tools, designed to assist workers’ compensation claims professionals in the forecasting of individual medical claims, have earned credibility and distinction.
“Medical reserving is part of a claims adjuster’s job function. Typically, adjusters have limited or no tools at their disposal to forecast reasonable and probable medical treatment and costs for individual claims for the purpose of ensuring that insurance companies and employers establish and secure the necessary funds to pay for bodily injury/ accident claims,” explains Deborah Watkins, CEO.
The aggregate of medical claims contributes to an insurance company’s loss reserve, the estimate of an insurer’s liability from future claims, allowing the insurer to cover claims made against policies that it underwrites, typically comprised of liquid assets.
“Adjusters often fail to understand and forecast the costs associated with expensive medical treatments such as surgeries, medical devices and medications or the frequency of care that is likely to occur based on an individual’s diagnosis and comorbid conditions. Claims adjusters consistently miscalculate funds needed to pay for medical costs. There are just too many variables for a human to consider,” added Deborah Watkins. “Using validated tools, adjusters can forecast medical reserves confidently, at zip code level precision, to better manage and settle their claims.”
Care Bridge International hosts over 1 billion medical claim transactions and 2,800 Medicare set asides reviewed and approved by the Centers for Medicare and Medicaid services. The Company offers the only InsureTech software solution using BIG data to forecast medical exposure for medical reserve setting/ medical cost projections and Medicare set asides for workers’ compensation and Liability claims within minutes instead of days or weeks. The company also offers an integrated risk management platform with dashboard analytics.
Care Bridge International’s leadership team has extensive insurance claims, clinical and data analytics experience and is passionate about delivering this big data solution to drive efficiency, transparency, risk management and lower costs for the claims value chain.
Source: Care Bridge International
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