Our Administrative Services
Our complete claims services are designed to help your company prevent losses, mitigate claim exposure, and improve outcomes. We partner with you to minimize your risk and exposure to control costs. Our philosophy is that the role of the TPA is to partner with its clients to develop a program that meets the needs of the client. We do not look to impose a particular business model, but rather we work to collaborate while offering suggestions based on our experiences, but ultimately working to implement the business model that is best for our clients. Our top priority is your top priority.
- Workers' Compensation
Our claims professionals strive for the best outcomes while ensuring opportunities for cost savings are maximized. We can provide significant savings for clients through our national medical networks. Inside South Carolina the savings are even greater through South Carolina's largest health insurer's PPO network. Our results are achieved through building deep client relationships, flexibility and commitment to quality.
Integrated Benefit Model
The integrated model focuses on the employee along with hiring and maintaining a healthier workforce. PAI will diligently work with your team to reduce work-related injuries while also facilitating return-to-work and improving quality and access to medical care.
- Preventive Programs/Consulting: Job assessments and post-offer pre-employment testing.
- Streamlined Workflows: Integrated return to work information, optimized quality care provider programs, and shortened return to work days.
- Employee Care Management: Combined workers' compensation and commercial health care strategies, and coordination through our population health unit.
- Enhanced Analytics: Detailed accounts of treatment on each injured employee, provider data to guide treatment plans, and program performance to ensure success.
Learn more about our model and actual client results.
- Commercial Auto, Property & Liability
We give your company the benefit of relying on one strong, experienced team to manage your commercial auto, property, and liability claims.
Our Services
- Risk Analysis and Reporting
We partner with clients to help reduce the claim’s costs associated with all lines of insurance by providing analysis on your unique risks. Our online tools provide information on strategies to assist you in creating safer workplaces to protect your employees and help reduce your claims exposure.
- Premium Audit
We offer audit services for commercial lines insurance policies subject to audits at expiration or upon cancellation of the policy term. In certain circumstances, we may perform an interim audit during the term of a policy to help determine the correct or adjusted premium for that policy period.
Premium audits play a vital role in the insurance industry because they obtain information needed to not only calculate premiums accurately, but also to establish future insurance rates for insurers. We will help you ensure your audit accurately reflects your company’s business.
Our Skilled Experts: Twice the Experience
Our high-quality claims team is part of one of the strongest TPA teams in the Southeast. With twice the industry average claims management experience, our team works as an extension of your team. Troubleshooting and problem solving, with a steadfast commitment, to deliver the best results for you. Your claims management team will work with you to find better ways to manage your claims and save you money long-term. Your claims management team is dedicated to quick response times with a proactive approach to returning the injured employee to work, improving claim outcomes and mitigating exposure.
- Dedicated Claims Representatives
Our staff has very low turnover. We collaborate with you on your account, so you can build trust and longevity with a dedicated adjuster who understands and anticipates your company’s needs. Working to meet your goals and maximize your financial results, our staff takes pride in protecting your business.
Benefits
We find ways to save you money, while providing excellent claims management services in all lines of business. Known in the industry for our experience, knowledge, and continuity, we are the skilled partner you can count on.
Our Quality Control Plan
Our Quality Control Plan sets us apart from the competition. It’s your assurance of the highest standards in claims management. Our high standards for quality claims management can mean lower claims costs for your company.
Performance Standards
Adjusters are managed and scored on their performance for accuracy, timeliness, and best practices. Cases are monitored daily and monthly production reports measure claim closing ratios.
Lower Caseloads
Adjusters’ caseloads are below industry standards in order to give you a higher level of personal service. They are skilled problem solvers, empowered with the flexibility to be creative and innovative in managing your claims and saving you money.
Quicker Response Times
Our performance standards, consistent monitoring, and documented reports work together to ensure your claims are managed timely and accurately. And, our business intelligence tools keep you informed throughout the claims process.
Cost Savings
We strive to be good stewards of your claims dollars. That is why we work so hard to control costs. Our managed approach can save you thousands in unnecessary medical costs.
Controlling Costs
We can assist you in analyzing your data to find ways to better manage your claims and help you control total risk costs. Our trained adjusters understand anatomy and review proposed treatment plans to identify caregivers who deliver quality, timely and appropriate medical care to help injured workers return to work sooner.
National Medical Networks
Our access to several national medical networks helps us achieve the best possible savings for you. In South Carolina those savings are ensured by our exclusive access to South Carolina's largest insurer's PPO network. These medical cost savings are part of our advantage that help us exceed your service expectations and maximize your financial results.
Medical Bill Review
Our comprehensive claims administration solutions provide efficient and accurate payment processing among multiple PPO networks to achieve maximum savings per bill. This best practice is our assurance that injured workers receive the highest quality care while managing medical expenses to reduce the total cost of your claims.
SSAE Compliant
We are compliant with the SSAE 16 professional standards for best practices as set forth by the American Institute of Certified Public Accountants, which ensures the integrity of our systems and procedures.
Client Resources
Provider Directory
Welcome to PAI's property and casualty administrative services' online provider search tool. With a variety of options, this tool will assist you in identifying and locating medical providers within a specified distance of any address. The efficient search options will allow you to quickly identify the provider type you are looking for and print a provider listing or medical posting as needed.
Data Reporting
We realize you have unique data reporting requirements. We provide you with dynamic claims reporting and analytics customized for your business, which allows for informed decision-making. We also provide a secure self-service tool for you to access your historical data. For information on how to access this service, please contact your account manager.