Who we serve / Payer side
For the organizations responsible for payment.
Payer-side and business-to-business throughout. Scout works for the carriers, administrators, adjusters, employers, and public entities that pay medical bills—never for the parties that send them.
Five kinds of client
Different seats. The same deliverable.
Open a segment to see what Scout is set up to do for it.
01Insurance carriers
Program control at scale, with the evidence to match.
- Program-level rules, thresholds, and authority, applied consistently
- Service-level reporting from clean receipt
- Savings classified by source, never blended
- A retained audit trail on every bill
- Integration with your claims workflow where it helps
02Third-party administrators
Consistent output across every client you administer.
- Consistent explanations of review, client to client
- Client-specific rules honoured without a separate process
- Queue visibility for your examiners
- Transparent hand-offs when a bill needs a question answered
03Independent adjusters
Fast per-claim submission and a clear deliverable, without an enterprise bundle.
- Submit a bill, get a status, get an answer
- Direct visibility into where each bill stands
- A line-item explanation you can forward as-is
- No minimums and no bundle to buy into
04Employers and self-insureds
Configurable control over what gets paid and why.
- Configurable thresholds and escalation
- Preferred-network application inside the review
- Management reporting that reads like a document
- A documented basis for every reduction
05Public entities
A documented method that stands up to review.
- Documented methodology, available for review
- Secure handling through controlled channels
- Reporting in the shape your program requires
- A retained audit trail for every bill
Two ways to work with Scout
Program or assignment.
Institutional program relationship
Scout reviews the bills for a defined program under agreed rules, thresholds, service levels, and reporting. The relationship is with the organization; the work is continuous.
Focused claim or account assignment
A single claim, a single account, or a defined set of bills, reviewed to the same standard with the same deliverable. No bundle, no minimum.
Either way
Tell us what you've got.
Describe your program or your claim. We will tell you plainly which motion fits and what it would take.
Request an assessment