Better outcomes for the Garden State

Since 2001, we have been providing New Jersey insurance carriers with the solutions needed to stay in compliance with the Automobile Insurance Cost Reduction Act of 1998 (AICRA). Our vast experience in the New Jersey auto insurance market allows us to help control insurer costs and increase claim efficiency.

Decision Point Review (DPR)/Pre-Certification

For insurance carriers looking for a more dynamic approach, we offer a comprehensive DPR/Pre-Certification program for New Jersey treating providers to submit treatment plans for review. This program is customizable, including the delivery of information to an insurer’s claim system.

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Attending Provider Treatment
Plan Form (APTP)

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Care Path

Our Nurses and Physicians review APTPs and make recommendations based on medical protocols

Our Nurses and Physicians oversee claims through all decision point intervals of the care path

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Advanced and Quality
Information

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Nurse Case Manager

Our Advanced Technology delivers streamlined adjudication and reimbursement recommendations

Dedicated Nurse Case Managers oversee the entire DPR process from start to finish

Our Advanced Technology Offers Easy Access and Organization of Claim Data and Medical Documentation

Our Technology allows visibility of the entire life of the claim, and also provides easy access and organization of all claim data and medical documentation.

Easy Fast Organized workflow chart

Reporting and Analytics

New Jersey Solutions

Prospective Case Management

Offered with our DRP/Pre-Certification services, the Prospective Case Management approach proactively manages the case from beginning to end by employing direct contact with all parties at the point of referral and at regular intervals throughout the life of the claim.

  • OUTBOUND CUSTOMER CONTACT
    We provide both initial and ongoing contact with all parties involved at 30-day intervals
  • DETERMINATION OF CARE PATH/MEDICAL PROTOCOLS
    Nurse Case Managers determine course of treatment and conduct discharge-planning assessments with the treating provider
  • DETERMINATION OF INDEPENDENT MEDICAL EXAMINATION
    A team of best-in-class physicians will assess the necessity of ongoing medical care and are available for testimony
  • ASSESSMENT FOR SPECIAL INVESTIGATIONS UNIT REFERRAL
    We’ll assess the need for submitting the claim, specifically when circumstances indicate potentially suspect activity

Professional Review

In cases that require specialized review, files are electronically routed to the appropriate professional, to help you better understand your claims and lower your risk of errors.

NURSE CASE MANAGER
ISG nurses will handle your treatment requests and file reviews

  • Administer NJ Decision Point Review Programs
  • Facilitate contact with treating providers
  • Provide treatment assessments

NURSE REVIEW
ISG on-staff nurses will help you understand the injuries and treatment in question

  • Bill Review
  • Bill Audit
  • Ask the Nurse (medical necessity, relatedness, appropriateness of charges)

BILL AUDIT
Services, procedures, and medications administered and billed appropriately

  • Provider/Hospital Audit
  • Desk Audit

PHYSICIAN REVIEW
Physicians are Board-certified, credentialed, and cover all specialties

  • Physician Advisor
  • Peer Review
  • Independent Medical Exam (IME)

CODE REVIEW
With the number of injury codes dramatically increasing, our certified professional coders will review the appropriateness of the billed procedures based upon AMA guidelines

LITIGATION HANDLING
We’re here to answer billing inquiries, investigate issues, and support insurers in resolving disputes

  • Provide written review of the case
  • Assemble appropriate documentation
  • Makes recommendations for resolution