Claims Adjudication
Do what you do best...
KRMA is proud to be able to offer our clients access to both our in-house claims auditor and clinical analyst, as well as our partnerships with specialized and efficient claims management service providers in the self-funded industry under our DoZEN platform.
KRMA’s partnerships are built on three fundamental goals:
- Allowing KRMA to focus on our core business expertise of underwriting stop loss programs and providing consultative solutions to our clients.
- Establishing an affiliation with reputable claims management teams that combine innovative technologies with specialized professionals to provide prompt and proficient claims adjudication services.
- Upgrading the claims reimbursement experience for our policyholders with an independent reviewer that delivers an unbiased interpretation of their claims that can be validated through industry benchmarks.
We have structured our relationship so that all parties work on one business platform to ensure that the process of policy administration to claims adjudication to reimbursement remains seamless for our policyholders.
Claims Submissions
For 50% notices, trigger diagnosis reports, high dollar notices, case management notes, and aggregate reports, please send to potentials@kismetrisk.com
For monthly accommodation, aggregate and specific claim reimbursement requests and inquiries, please send to claims@kismetrisk.com
