Performance driven. Results-oriented.
Sharing our expertise gained from holistic LTCi block management.
LTCi Block Management
Since its inception, Fuzion has been holistically managing one of the oldest closed blocks of long-term care insurance. Fuzion was formed with many leaders and associates holding deep LTCi experience in claims management, insurance operations, financial management, and analytics. Fuzion’s success is driven by its focus on analytics underpinning decision-making. Proprietary processes and systems, powered by data scientists, gather and organize data so that claims handlers, operations analysts, SIU investigators and management can be informed with meaningful information with which to guide their activities and decisions.
Fraud, Waste, and Abuse Prevention
Fraudulent claims are harmful and costly at every level of the senior care industry. Unfortunately, incidents of fraud, waste, and abuse are only growing more prevalent. Fuzion is emerging as a best-in-class solution for the identification and reduction of fraud. We combine effective data mining tools and investigative techniques to pursue wasteful claims and ensure that payment for care is appropriate.
Sentinel
Fuzion’s Sentinel platform attacks fraud and abuse from many angles. It is an industry-leading framework for managing the auto-identification of claims at risk for potential fraud, waste, and abuse.
Data Analytics
In our data-driven industry, there is no such thing as too much insight. Fuzion has created the tools that allows us to inform carriers, with precision and certainty, what is happening within a block of insurance. Our tools are holistic, allowing for the early identification of trends, as well as enabling our clients to focus their attention on the items that will have the biggest impact upon their bottom line. With industry leading software and experienced specialists to effectively interpret the results, we empower long-term care insurance providers to operate from a place of knowledge and clarity.
PULSE
Fuzion’s Pulse platform is our proprietary business intelligence tool, enabling Fuzion to measure the performance of blocks of long-term care insurance.
Audit and Oversight
Fuzion’s role as a third-party manager for long-term care insurance carriers creates an inherent proficiency in providing audit and oversight services for carriers seeking a standalone service in this area. Fuzion has the capacity to field an audit team that consists of a blend of professionals experienced in the LTCi segment, all who have participated in or led claims audits for LTCi clients in the past. Audit team members are heavily involved in claim review and oversight in their day-to-day roles at Fuzion.
Claims Management
The Fuzion approach helps better manage the incidence and severity of claims. The expenditures for long-term care are roughly split 90% on the claims experience and 10% on processing claims. While many carriers have efforts in place to improve upon their administrative processes, larger bottom line impacts can be realized by being laser focused on the claims experience. Fuzion's approach in guiding carriers through efficiency gains significantly benefits its clients’ financial performance.
