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Otherwise known as the Claims Leakage AI Mitigation Tool, this technological innovation has been specifically formulated to minimise the degree of Claims Leakage that is endured by both insurance companies and self-insurers.
What is Claims Leakage? This happens when payments for surgical, or other treatment expenses, are incorrectly paid at an amount that is higher than the rate prescribed by the Australian Medical Association (AMA) for that specific service. Companies are wrongly left out of pocket for thousands or even millions of dollars all due to the careless errors of their Claims Managers and other staff who routinely approve incorrect amounts when granting requests for treatment.
The AMA has listed the payment rates applicable for all surgical and other recognised forms of treatment in their all-inclusive Fee Schedule. Item codes have been assigned to every single type of service. Therefore, Specialists need to state the correct AMA codes on their surgery requests to insurance companies.
Although Claims Managers are required to check all requests and invoices they approve, insurance companies commonly end up paying well above the AMA designated rates, due to the inattentiveness of their employees.
In keeping with our dedication to helping our clients avoid incurring unnecessary fees, the Claims Leakage AI Mitigation Tool provides a way for your staff to check the correct fees for any surgeries they are approving or arranging payments for.
Fast and easy to use, your staff simply enter the name of the requested treatment to find the appropriate AMA code and its associated rate. Once confirmed, your staff can then communicate the correct amount they agree to pay in their approval letter to the Specialist or allied health professional.
Designed to save your business thousands of dollars in claims leakage every year, the Specialist Invoice Check is just another fantastic reason to choose MAG for the most state-of-the-art insurance solutions.