Explore Our Claims Administration Services

Comprehensive and efficient claims administration tailored to your unique requirements

Our Services

Alpha Isle Services specializes in high-quality, expedited back-office claims management.

Whether you need full-time claims staff or support during peak seasons, our comprehensive claims management services are designed to meet your needs effectively.

With AIS, you can rely on responsive, accurate, and timely administration. We apply appropriate contractual provisions, plan specifications, case management resources, and established claims practices to each medical claim, ensuring proper reimbursement or denial.

  • Claims Intake
  • Notice Tracking and Notification
  • Document Management
  • Payment Recommendation
  • Reinsurance Reporting & Tracking
  • Customized Reporting
  • Participation in Implementation Calls

Managing Claims Workloads

AIS operates with a standard of a 10-day turnaround for claims.

If your current claims backlog exceeds this timeframe, AIS can help bring your claims processing back under control. We handle overflow efficiently, ensuring you stay within industry standards and avoid potential service issues with MGUs, producers, and insureds.

AIS managing claims workloads

Operational Assessments

With extensive experience in running medical stop loss claims departments, AIS is well-equipped to consult on the operations of MGUs or insurance carriers’ claims departments.

An insurance carrier granting claims authority to an MGU will have a right to audit the MGU’s claims handling practices, but equally an employer or a captive which is responsible for payment within a specific and/or aggregate layer will want assurance that claims are being managed appropriately and payment are correct.

  • Setting Up Claims Departments
    AIS assists in establishing claims departments by providing procedural manuals and guidance on staffing and technology needs.
  • In-House Claims Administration
    For those transitioning to in-house claims administration, AIS offers support in managing and overseeing your claims team to ensure smooth operations.
  • Periodic Assessments
    AIS provides periodic operational assessments or check-ups to identify areas for improvement in your claims department.

Claims Audits & Reserve Analysis

In the employer stop loss market, various stakeholders need assurance that claims are reserved and paid correctly.

AIS, with its specialist claims administrators, offers extensive experience in managing stop loss claims and conducting thorough audits.

  • Large Individual Claims:
    Ensuring accuracy and appropriateness in handling large claims.

  • Periodic Audits:
    Regular reviews of claims departments to maintain high standards.
  • Aggregate Claims Review:
    Comprehensive audit of aggregate claims to confirm correct handling and payment.

Contact Us

Let’s Talk!

For more information about our services please use the form.  One of our representatives will get back to you right away.  We look forward to hearing from you.