CLAIMS REGULATORY COMPLIANCE SERVICES

Get in compliance – and stay in compliance.

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Are you struggling with compliance?

Successfully navigating the complex rules and regulations to stay in compliance is a big job – with even bigger consequences. Fines for noncompliance are so steep, even a few errors can mean huge dollars. Do you have what it takes to achieve compliance?

Stay in Compliance

Riskonnect has a fully dedicated Regulatory Compliance Team to help you achieve and maintain compliance. With deep industry and regulatory knowledge, our team ensures that our regulatory compliance functions remain current. They can assess your current compliance processes, evaluate your risk of noncompliance, and make recommendations for maintaining compliance in the future.

Our highly experienced professionals stay on the leading edge of jurisdictional requirements and help shape industry standards by holding membership and leadership positions with the IAIABC and other industry organizations.

Our Focus

  • First Report of Injury (FROI) and Subsequent Report of Injury (SROI)
  • CMS Section 111 reporting
  • Workers’ compensation state forms
  • NCCI medical data call reports
  • Other regulatory functions

Our Process

  • Supports self-insured, self-administered, TPA, carrier, and healthcare marketplaces.
  • Proactively monitors legislation and regulations.
  • Ensures mandated compliance rule changes are applied by the required dates.
  • Maintains a comprehensive library of current state forms, which are updated whenever regulations change.
  • Taps into a vast industry network to define best practices, resolve issues, and develop the most effective regulatory solutions.
  • Assesses the gap between current and future workflows, procedures, and documentation.
  • Reviews CMS and FROI/SROI transmission, acknowledgements, and responses for critical compliance issues.

Our Solutions

  • Manage and automate required regulatory functions.
  • Resolve regulatory transmission errors and increase jurisdiction acceptance rates.
  • Ensure compliance with critical claims regulatory requirements.
  • Improve FROI/SROI and CMS workflow, configurations, and documentation.
  • Sort out complex regulatory issues that require expert-level involvement.
  • Provide recommendations for immediate, short-, and long-term actions.

How’s Your View?

Find out how Riskonnect can transform the way you view risk.

Schedule a Demo