The Claims Department at Risk Services & PBOA is committed to timely payment and provision of benefits. We have distinguished ourselves from others in the industry by combining proactive claim management with expert investigation. Our aggressive but fair approach ensures we only pay benefits that are due. The result is a reduction in your overall claim costs.
Each claim that is handled by Risk Services & PBOA includes the services listed below.
In order to manage claims and costs one rule remains constant. The faster a claim is reported, the lower the claim cost can be. Risk Services & PBOA ensures the convenience of reporting claims, 24 hours a day, seven days a week to policyholders and/or agents. Reporting can be done by phone, fax, mail, or email. Once reported, our staff will review the details and pursue contact with the medical provider, employer, and the injured worker within 24 hours when necessary.
Our experienced and dedicated claims professionals are
focused on expertly managing your claims. Following a thorough investigation from beginning to end, our office and field investigators work toward a final resolution that delivers superior service and fair results that you expect and deserve.
Medical Bill Review
Our highly skilled team of medical bill reviewers control and reduce costs by consistently applying all usual and customary discounts and fee schedule reductions to each medical bill received. In addition Risk Services & PBOA partners with a preferred provider organization for contract discounts in claim costs.
Medical Case Management
We have office and field case managers with multiple years
of professional experience in medical care coordination.
Using cost management strategies our nurses ensure the
most appropriate and timely medical treatment is provided.
This achieves optimal results for the restoration of function
and return to work.