Carrier use cases · Claims expense accuracy

Catch claims expense errors before they become paid expenses.

VIP applies carrier contracts, fee schedules and business rules across claims expenses, so exceptions are identified before payment rather than discovered afterwards.

Map a claims workflowAll use cases
The problem

What gets in the way today.

Carrier contracts and fee schedules contain detailed rules. Applying those rules consistently across large invoice volumes creates significant operational work, and traditional manual audits examine only a sample.

Why the problem exists

  • Contract terms live in documents, not in the payment workflow.
  • Invoice volume outpaces the team available to review it.
  • Rate, unit and service-level variance is hard to see line by line.

What happens today

  • A sample of invoices is reviewed manually.
  • Variance outside the sample is paid without challenge.
  • Recoveries are attempted after the money has already left.
How VIP changes the workflow

Same claim. Different path.

Before VIP

Teams review what they have time to review, and accuracy depends on where the sample lands.

With VIP

Every invoice in the workflow is validated against the terms in force, and only exceptions need a human.

  1. Invoice received
  2. Contract and fee schedule validation
  3. Business-rule validation
  4. Exception identified
  5. Review
  6. Approved amount
  7. Payment
  8. Performance intelligence
Evidence

What the pilots actually showed.

100%of pilot invoices audited, compared with about 10% under the existing manual processObserved pilot result
2.16%invoice accuracy improvementObserved pilot result
~$51Kinvoice accuracy improvement identified during the pilotObserved pilot result

Results from a 60-day carrier pilot. Carrier not identified.

Business impact

  • Reduce leakage
  • Improve contract compliance
  • Reduce manual review
  • Improve vendor accountability
  • Create structured claims expense data

Where this sits in the claim

Pre-FNOLFNOLClaims OperationsExpensePerformancePaymentClosureIntelligence

Related VIP capabilities

Claims OperationsExpense intelligencePayments
Success stories

Evidence this has been done.

National P&C carrier modernizes claims expense control

How a national P&C carrier moved from sample-based invoice review to continuous claims expense control.

Read the success story →
Related use cases

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Automated invoice audit

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Invoice fallout

Catch exceptions upstream instead of sending them back to adjusters.

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Claims spend visibility

See expenses by claim, vendor, contract, geography and service.

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Bring us one claims workflow.

Show VIP where the friction exists. We will map the workflow, identify the operating gaps and show where VIP can create measurable value.

Map a claims workflow1-800-595-1065