TPA Best Practices #1: The Power of Automation

A 2016 workers’ compensation benchmark study found that half of all high performers employed automation at specific intervals in the claim cycle. Additionally, high performers were almost 4X more likely to rely on automation throughout the cycle than all other groups. Given that another workload study, which conducted over 4,500 interviews with claims professionals, found that adjusters spend up to half of their hours on non-core tasks, it is clear that removing administrative burdens on adjusters is critical to becoming a high performer in the industry.

Employing Workforce Automation with Origami Risk

The workload study estimates that the average adjuster has 130 open cases, with an average of 20 attachments per case, many of which are sent via email. If it takes an adjuster 1 minute to open the email, download the attachment, and then upload it into the case file, it would take one full week simply to manage those documents. With Origami Risk, this process takes seconds. When a case-related email with attachments is forwarded to a dedicated Origami address, the system verifies access rights to the proper claim based on the sender’s mail address. It then uploads the email message, along with all attachments, directly to the claim record.

Reducing the amount of time spent on repetitive clerical and administrative tasks doesn’t end with the ability to automate file attachments. In Origami Risk, numerous workflow automation options are available, including:

  • Custom notifications – Eliminate “one-off” composition of emails through the use of email templates and custom notifications triggered by events
  • Mail Merge Word Docs – Generate custom letters that are pre-filled with specified claim details, then make any changes necessary before sending
  • Regulatory Reporting – Automatically populate and transmit forms to regulatory agencies to ensure compliance
  • Approvals and payments – Generate checks with automated routing for escalation and approval. Interface with third-party systems to exchange up-to-date claim financial details.

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Using Automation to Shift from Reactive to Proactive

The same easy-to-configure, event-based automation that can help your adjusters reclaim the half of their day lost to non-core, administrative activities can also be used to alert stakeholders the need for intervention and to keep customers informed. Supervisors or claim quality auditors can be notified as soon as cases trigger any condition that indicates potential issues—for example, under-reserved claims or reserve stair-stepping. Account managers can have custom reports automatically generated and emailed to stakeholders as soon as a customer reaches thresholds on self-insured retention or per-claim deductibles. By removing the daily noise, each level of management can focus on the areas where they will have the most immediate impact. Zeroing in on issues at the moment they bubble up shifts the focus from reactive to proactive.

Impact Throughout the Claim Cycle

The benchmark study also highlighted the impact that utilizing automation throughout the claim cycle can have. Origami Risk allows you to automate all levels of the claim cycle. From notifications and document management at the adjuster level, to trend notifications and automated PowerPoint template creation for account managers and the executive team, to automated report generation and distribution for clients, your organization can streamline specific processes at each stage.

Moving to Best-in-Class

Automation plays a clear role in building a best-in-class claims operation, which helps TPAs grow their business. With Origami Risk, harnessing the power of automation is simple. Free adjusters from administrative work and let them focus on closing claims, break down information silos, and help zero in on the most critical cases at the time when intervention can have the most impact on positive outcomes. Best-in-class organizations rely on automation to drive cost reductions through early intervention, reductions in administrative overhead, and faster claim closure. Origami Risk makes it easy for any TPA to employ best-in-class practices.

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