X-CLAIM Probe - Intelligent Field Verification & Investigations
How is X-CLAIM Probe different?
X-CLAIM - Probe stands out in comparison with similar service providers, on several fronts:
Web based app
Proprietary web interface www.xclaimprobe.com, provides real-time trigger based field activity, focused Plan Of Action (POA) created by a medico assessor to facilitate and ensure maximal results, field operatives are connected with doctors in COPS to facilitate results even from hostile providers.
Our experience of last decade and a half has proven, beyond doubt, that entry-level assessment and creation of a well thought Plan Of Action is the foundation of a justifiable case closure and has the capacity to make or break any field verification/ investigation.
Case uploads as well as reports delivery is through the app. X-CLAIM - Probe also offer archiving of reports and images obtained through field activity for a pre-defined time.
Empowered Medico Assessors
All the assessors at X-CLAIM - Probe are medical doctors with experience of assessing insurance claims. These doctors undergo rigorous, ongoing in- house training and have a huge Knowledge Repository (Over 6000 Items) at their disposal helping them decipher medical terms, abbreviations, Entire IPC & Cr PC, investigations and drugs etc.
Additionally they also have over 300 disease templates and over 100 Appropriateness Protocols of common hospitalization (ideal for LIFE AND health insurance) – painstakingly prepared in-house under guidance/ supervision of Padmashree Prof. Alaka Deshpande and Dr C H Asrani. These templates help them with checklist of documents required for rational decision-making w.r.t. individual ICDs.
20 yrs in insurance industry has also given us deep insights into the consumer behavior and physician attitudes, having assessed / audited more than 40,000 cases.
Team at X-CLAIM - Probe, also has at their disposal
- 7.5+ lakh doctors with medical council registration numbers
- 10,000+ hospitals
- 72,000+ drug brands
- 750+ Lab Investigations
- Largest industry data base of hostile providers
Real Time Medico support to trained field managers (FM)
Duly trained FMs have been empowered on what exactly to look for and in art of subtle questioning and observation. When the FMs are on the field, they are provided with real time support and the assigned Medico Assessor in the COPS monitors the case progress and triggers action should a road block come up.
Our robust processes have enabled us successfully offer a wide array of services to some of the larger insurers over last decade.
We use dedicated servers with a security certificate. Our IT team works in conjunction with client IT team and ensures compliance with all client needs. After all, who would understand confidentiality better than a doctor?
Large and in-depth experience in Private and Public Insurance Industry in India (Including life, general, critical illness, accident benefit rider and cases represented at legal fora) – over 15000 cases analysed/ investigated.
Rigid adherence to TAT
Technology based expert platform enables service delivery within rigid TAT with a specially designated TAT manager.
Where all is Probe available currently?
X-CLAIM - Probe is currently being offered to cover Mumbai & Navi Mumbai; Rest of Maharashtra, Gujarat state and Delhi.