The Alpha Claims Difference. Our medical canvass service provide you with in-depth information into the claimant’s medical history. Unlike the traditional index search Insurance carriers and TPA’S conduct periodically on a claim file, we look to find medical history that is pre-existing and personal in nature. Typically these are medical services your claimant seeks under his or her personal health insurance plan which your insurance representative has no access to when they conduct an Index search.
While we do not personally receive the medical records, we can obtain them on your behalf and have them sent to you directly from the canvassed facility. We find that Medical Canvasses are often assigned to surveillance vendors who hire clerical staff to perform these duties. Our canvasses are all handled by licensed claims professionals, what this means to you, is we have the expert claims professional mentality, we apply an out of the box approach which typically uncovers information wherein others fail to look — leading to greater success and return on Investment to our clients.
We succeed where others fail as there is no substitution for experience and sophistication. When the alleged injury is not recent, we will also ask the provider what years their records system references. Our efforts are focused on Identifying and defending against possible insurance fraud. Our services concentrate on the following principles:
Verify treatment and confirm the alleged date of injury.
Discover previous treatment for a similar injury.
Determine if the claimant has a history of prior claims.
Provide the insurance carrier or file handler with the knowledge of where and when the claimant has been treated, which can be especially useful in a deposition or when disputing damages in an Auto liability or Workers’ Compensation claim.
Bring to light treatment in another geographic locations.
Dispute the extent of the injury.
Locate the claimant’s primary care physician.
Confirm gym and sports club memberships.
Uncover addictions or drug-seeking behavior with a pharmacy canvass, or even by searching substance abuse counselors and treatment centers.
Determine whether the claimant has a history of depression, anxiety or sleep disorders by requesting a canvass of pharmacies and/or sleep testing centers.
Substantiate or disprove the claimant’s complaints and treatment history