Excess Claims Management
Delivering service, expertise, and dependability through our reinsurance claims management services
Significant Cost Savings & Quality Claims Reviews
We deliver a range of specialty reinsurance claims management services to risk-bearing entities, including insurance carriers, employer stop-loss coverage providers, MGUs, and hospital and physician organizations. Our highly skilled technical staff and proprietary claims system provide significant cost savings to our clients. Working with Davies means our clients spend more time on value-added activities for their expanding specialty product lines while our team focuses on providing the necessary internal staffing and claims processing platforms.
Davies monitors and evaluates the handling of self-funded employer stop-loss-specific claims, establishes reserves, and reports to our clients and intermediaries. Our specialists recommend reimbursement and deliver claim backlog support by directly accessing our clients’ claim platforms or using Davies’ reporting tools.
How We Help
- Monitor & Evaluate the Handling of Self-Funded Employer Stop-Loss Claims
- Establish Reserves
- Provide Extensive Reporting
- Reimbursement Recommendations
Our Achievements
14K+
Claims Audited in 2023
$24B
Annual Stop-Loss Employer Value
30+
Years of Experience
17%
Annual Increase in Million-Dollar Claims Across the Industry
$350M+
Annual Provider Excess of Loss Premium
Claims Management & Auditing Solutions for Employer Stop-Loss & Managed Care
We evaluate the handling of self-funded employer stop-loss-specific claims, establish reserves, and report to our clients and intermediaries. We deliver reimbursement recommendations and claim backlog support through your claims platform or our reporting tools.
We analyze risk exposure in data submissions, provide claim review recommendations and reporting, and draft policy language for the managed care market. Our clients rely on us to resolve coverage issues and deliver recommendations regarding specific managed care risk-bearing providers, TPAs, HMOs, ACOs, and other health plans.
Our proprietary claims system is one of our key differentiators for specialty reinsurance claims management. This system completely automates the fee schedule process and claims submission activity. Our team quickly identifies duplicates and streamlines the data process for millions of transactions.
Key Contacts
Dave Valenzano
President of Actuarial, Audit & Consulting