Fraud, Waste, and Abuse
Incidents of fraud, waste, and abuse are growing more prevalent in the insurance industry. Long-term care insurance claims have continued to steadily increase over the past decade with a corresponding increase in FWA. Fuzion was among the first to recognize this trend and its financial impact. Our early development of strategies and actions to identify, investigate, and mitigate FWA is recognized as a best-in-class solution in the LTCi industry.
Benefit Eligibility and Case Management
Managing the claims process is critical to a long-term care insurance carrier’s success and requires an enormous amount of time, effort, and experience. Today’s staffing and other issues are creating a variety of challenges for carriers. Fuzion’s services have been developed to address these industry challenges. Our services aid in researching and resolving customer disputes, assessing benefit eligibility and providing decision support, evaluating processes and procedures, and recommending ways to improve claims and case management functions.
Fuzion stands ready to provide carriers with a variety of consulting services, including comprehensive claim audits performed by professionals with deep LTCi experience.. Fuzion has been recognized for designing and producing award-winning policyholder communications. These communications explain premium and benefit modifications in a way that is comprehensive and easy to understand, boosting customer satisfaction and building a carrier’s reputation. Fuzion also helps carriers enhance their policyholders’ experience through sharpened and streamlined communications, improved operational efficiencies, and staffing resources to help carriers manage their complex LTCi business.
Many insurance companies face the challenge of improving financial and operating performance of their troubled long-term care blocks of business. Fuzion’s team has unique and extensive experience in providing planning and implementation services to improve the performance of underperforming blocks of LTCi business. Fuzion's leadership team is highly qualified in managing LTCi companies and blocks of business.