PROJECT MANAGEMENT / CONSULTING
As the TPA industry evolved from simple claims processing to more automated transaction management, HGI has embraced the change and leveraged its capabilities to provide transaction processing services. This enables our customers to streamline their operations and focus on their core business. In addition to the cost savings realized by outsourcing this function to HGI, customers also benefit from an improvement in quality.
HGI evaluates each customer’s individual needs and creates a solution that meets the goals for security, accuracy, and quality. Our experienced and highly talented staff combined with state-of-the-art technology means our clients can be assured they are receiving the best solution in the industry.
We have vertical market expertise in several areas including credit card, insurance, mortgage, medical and rebate claims processing. For example, HGI’s Healthcare Division has experience providing enrollment and billing transaction services to over 2,400 employer groups a day. Our ability to manage such a large volume of transactions was validated in 2007 when HGI was contracted to process over $3.5 billion in claims filed by citizens of Louisiana as part of the “Road Home“ project following Hurricane Katrina.
HGI supports the entire transaction processing life cycle, providing clients with a solution that increases productivity while reducing costs.
Audit Recovery Services
Overpayments and other financial errors can have significant impact on a company’s bottom line. HGI Audit Recovery personnel are trained to identify and recoup overpayments, as well as recommend processes and procedures that will help eliminate future recurrences. We specialize in insurance claim and medical bill audits. Our comprehensive process identifies even the most difficult-to-find errors and provides customized cost-saving solutions for your business.
Financial Examination Service
HGI financial examiners can perform examinations of companies’ accounts, financial and operating statements, reports, and other records which reflect company operations. Our examiners will ensure that the company has properly adhered to provisions of laws, rules, regulations, industry policies, legal opinions and court precedent to examination findings. They can also help customers prepare reports that are clear and concise and contain specific and general information on company financial conditions.
Loss Reserve Analysis
HGI analysts will review all relevant data to provide a professional opinion regarding the loss reserves required for unpaid claims. Whether the analysis is required to meet regulatory or financial reporting criteria or is part of an audit process, you can be confident with an HGI analysis. Common uses of a reserve analysis include:
Actuarial reserve certification
Satisfaction of self-insurance requirements
Negotiation of security and letters of credit requirements
Acquisition due diligence
Evaluation of expected liabilities for financial statements
Regulatory Compliance Consulting
HGI experts help companies interpret regulatory rulings and implement compliance reporting activities. With nearly eight decades of experience, HGI has a long history of helping customers understand the regulations and statutes that impact customers’ insurance coverage. HGI experts can be enlisted to assist with the demanding financial requirements that accompany financial and insurance service reporting. Our services include:
Statutory Actuarial Roles
Risk Management Consulting
HGI certified Risk Managers work with customers to ensure profitability and avoidance of capital loss through implementation of an effective risk management program. HGI works with the customer to ensure that risks are effectively managed and priced, as well as ensure that effective risk procedures are in place and followed. This process also helps provide senior management visibility to the risks and the potential losses.
HGI has developed an assessment process to quantify and evaluate the overall risk inherent in the book of business. We then utilize existing statistical and actuarial tools and capabilities to ensure the risks in products are appropriate. As part of this service, HGI will evaluate and provide feedback to the customer on the effectiveness of risk mitigation strategies employed via both public and private reinsurance tools.
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