Mastering the Garden State's Auto Insurance Landscape
New Jersey auto insurance regulations are complex—which is exactly why carriers need specialized expertise to master them. Since 2001, ISG has been a trusted partner helping carriers navigate AICRA’s intricate requirements while turning compliance challenges into competitive advantages.
Here’s what two decades in the trenches has taught us: The carriers who thrive in New Jersey don’t just check compliance boxes, they streamline processes to turn regulatory challenges into operational advantages, leveraging AICRA’s frameworks to control costs, accelerate resolutions, and deliver outcomes that satisfy regulators, policyholders, and bottom lines.
That’s exactly what we help you achieve.
Decision Point Review (DPR)/Pre-Certification
Where treatment plans meet smart claim strategy.
Our DPR/Pre-Certification program provides a collaborative framework where good medicine and smart claims management work together. Every treatment plan submitted becomes data that helps you understand injury patterns, provider behaviors, and cost drivers across your New Jersey book of business. We leverage this information to make informed recommendations that support positive claims outcomes.
Attending Provider Treatment Program (APTP)
Our nurses and physicians apply evidence-based protocols that ensure claimants get the most appropriate level of care while assuring benefits are preserved. Each review becomes a building block in developing more effective claim strategies.
Care Path Management
Claims can change direction quickly. Our experienced nurses oversee every decision point and work closely with our physicians, identifying potential complications early and making treatment recommendations to assure the most appropriate level of care and treatment.
Advanced Technology Integration
Our technology transforms adjudication and reimbursement processes. Automated recommendations, integrated workflows, and real-time status updates mean faster decisions and better outcomes.
Dedicated Nurse Case Management
Every DPR case is managed by an experienced nurse case manager who is proficient with NJ AICRA. Their medical expertise allows the appropriate use of medical management protocols to assure the most appropriate decision making for medical care.
Prospective Case Management
The difference between a good claim outcome and a great one often comes down to timing. Our prospective case management approach is offered with our DPR/Pre-Certification services to identify opportunities and risks early. Our proactive approach allows us to take actions to steer claims toward optimal resolutions before they drift into expensive complications. Think of it as preventive medicine for your claims.
Outbound Customer Contact
Every 30 days, we’re connecting proactively with all patients, to obtain important medical and treatment status. These are strategic touchpoints that help to build a positive relationship and provide support for all parties involved in the claim to move the file towards resolution.
Determination of Care Path/Medical Protocols
Working directly with treating providers, our nurse case managers help ensure treatment paths are appropriate, cost-effective, and aligned with best practices while planning for optimal discharge outcomes.
Determination of Independent Medical Examination
We’ve curated a network of physician specialists across every medical discipline that are available to assess the necessity of ongoing medical care. Our physicians are available for testimony when disputes escalate.
Assessment for Special Investigations Unit Referral
Our nurse team uses clinical expertise and skills during the claim review process to identify potential activity that may warrant investigation.
Physician Services
ISG maintains an exclusive medical panel of over 16,500 independent physicians who provide medical professional services. Representing a broad range of specialties, these medical professionals support positive claim outcomes, providing defensible decisions backed by unassailable expertise.
Physician Reviews
When a physician’s professional assessment is needed, our diverse panel of specialists evaluates medical documentation to determine treatment relatedness, appropriate care duration, and medical necessity.
Peer Reviews
We match every peer review case a physician who practices in the same medical specialty, ensuring relevant expertise for every review. These peer specialists analyze medical records and deliver comprehensive case summary reports that address causality, treatment appropriateness, and medical necessity with specialty-specific insights.
Independent Medical Exams (IME)
Our streamlined IME process connects you with board-certified specialists nationwide. We coordinate all logistics—from scheduling to specialist selection—ensuring efficient, credentialed examinations that meet your timeline and requirements.
Provider Resources
NJ DPR Plans
New Jersey Decision Point Review Plans
Join Our Network
We’re always seeking board-certified specialists who share our commitment to evidence-based treatment and efficient claim resolution. To inquire about participation in the ISG physician review network, please email or fax us.
Email: Networkdevelopment@isgvalue.com
Fax: (732) 626-6892 (attention: Network Development)
