Ensuring healthcare quality and reducing claims costs are not mutually exclusive. That’s the simple proposition at the heart of RGA’s health claims services, a bundle of tools and services designed to empower you to process high volumes of health claims rapidly – while managing risk accurately.
Given the right clinical and technical support, claims teams can balance high customer expectations with tight timescales with limited resources.
As a global leader in life and health claims, we understand today’s complex healthcare and claims environment. Insurers must efficiently allocate resources between higher- and lower-risk claims, interpret complicated policy language, and make use of tools and data-driven insights to fight fraud, waste, and abuse.
Our claims management team brings decades of experience and specialized medical knowledge to better assist clients assess, benchmark, and manage risks.
Partner with us to benefit from deep technical knowledge, enhance product designs, improve staff training and development and enhance operational efficiencies. Also, know that your reinsurer is aligned with your claims evaluation and settlement processes, and will support your reinsurance claims
Access an ecosystem of cost-containment provider networks, services, and technologies, such as RGA’s Automated Solution for Claims Leakage (RASCL), a powerful claims validation tool for identifying high-risk claims. RGA’s best-in-class actuarial and data science capabilities, paired with deep experience with providers, such as third-party administrators, can guide better decisions in a competitive landscape.
Connect with claims experts, physicians, and clinicians through RGA’s health claims services and protect your bottom line. Our team has the experience to review your operations for efficiencies and quality and assist you in assessing all types of claims challenges.
Gain from our knowledge. RGA clients can access professional claims education and training, from Pathfinder e-learning to market seminars, conferences, webinars, and client-specific sessions. Or manage change and make more informed claims decisions with ¹ú±êÂ鶹ÊÓƵAPP highly regarded Global Claims Manual, as well as value-added publications such as Global Health Briefs and Drug Watch, benchmarking research and surveys, and much more.
Medical Director and Health Claims
RGA Global Medical
Process high volumes of health claims rapidly – while managing risk accurately – by partnering with RGA.
