Monthly Archives: Apr 2018

Evaluating a RMIS: What questions should you be asking vendors?

Your internal assessments suggest that it’s time to move forward with the purchase of a new RMIS. In our recent post, “Tips for Selecting the Right RMIS“, we looked at potential next steps that range from considering the inclusion of other departments in the selection process to researching vendors to suggestions on what to look for in a new system.  As you move into the next phase of the buying process, to ensure you get the most out of your investment, there are many questions to ask vendors when evaluating their RMIS offerings.

Consider grouping the questions into five categories: read more

Supercharging your claims handling

TPAs continue to face increasing pressure to find more innovative ways to drive efficiency and do more with less. An article in Lexology states, “Automated claim processing is the future for insurance carriers, third-party administrators (TPA’s) and large employers, to improve efficiency and reduce the resources required to process claims.” Determining a strategy for automating claims handling can be challenging.

A recent post examined the ways top performers approached automation. One key benchmark study of differentiators recommended: “Employ claims decision support tools – such as workflow automation, advanced analytics, and predictive modeling – and use them more frequently throughout the claim lifecycle.” In fact, top performers are 4X more likely to use automation throughout the cycle than all others.

To achieve the results similar to those of top producers, a comprehensive approach to improvements through technology must be employed. read more

Improving the claims process with an integrated claims administration system

Improve the claims process with an integrated claims administration system

What stands in the way of a more efficient claims administration process? For too many organizations the answer to that question is a reliance on disparate systems, including the use of outdated legacy claims management systems.

The adoption of an integrated, SaaS claims management system that combines workflow automation tools with all of the functionality needed for end-to-end claims adjusting can be transformative. read more

TPA Tech Guide #2: Improving customer communication

A recent Business Intelligence article draws from a Redhand report claiming that “of all of the subsectors of the RMIS industry, the third-party administrator sector is the one that is the most in transition.” The article suggests this may be due to the fact that TPAs are trying to remain competitive while relying on fewer resources than insurers.

What is clear, according to the Redhand report, is that TPAs are trying to level the playing field with technology. “As will become obvious, there has been a lot of investment and improvement in the TPA sector regarding information technology…” The larger question is, are these substantial investments in upgrading systems even focused on the right area? A survey of customer data indicates this may not be the case.

read more

Taking control of the values collection process

The use of RMIS technology that has been designed to handle the values collection process can help to reduce the amount of time risk management teams spend gathering data.

For risk professionals, the conclusion of a 2017 risk management survey will likely come as no surprise: “Risk Managers, regardless of experience level, are being asked to do more with less.”

Nearly one-third (31%) of respondents indicate that given “additional time”, they would focus on improving internal processes. “The survey results point to Risk Managers being mired in the day-to-day task of servicing their internal constituents, making it difficult to pivot to the strategic questions being raised by their CFOs.” read more

Claims compliance and reporting: Choosing the right technology partner

To be sure that you’re selecting the right workers’ compensation claims compliance and reporting partner, a vendor’s track record is the closest thing to a “crystal ball” that exists.

“To stay competitive in today’s marketplace, companies need complex and multi-faceted digital capabilities,” writes Rashmi Dalia in The Economist. “However, no one company can easily possess all the resources needed to develop robust technology systems, and trying to do it alone can prove difficult and costly.”

For insurers and TPAs, choosing to work with a technology partner has increasingly become a critical strategic decision. 76% of respondents to a 2017 Accenture survey agree that “competitive advantage will not be determined by their organization alone, but by the strength of the partners and ecosystems they choose.”

Identifying gaps and areas in core systems where it makes the most sense to integrate third-party technology is one part of the challenge. Equally important to finding the right technology solution is having confidence in the people behind the technology. read more

TPA Tech Guide #1: Gaining a competitive edge

In the Accenture Technology Vision for Insurance 2017 Report, nearly 9 out of 10 respondents stated, “their organizations must innovate at an increasingly rapid pace just to keep a competitive edge.” Despite this technological arms race among TPAs, much of the focus remains on backend systems, which may drive some operational efficiencies but fall short in alluring tech savvy customers. read more

Growing your business through analytics — Getting started

A recent article, “Transforming into an analytics-driven carrier“, examines best practices in what is a multi-stage journey that requires equal parts business and analytics leadership. The end goal is an organization where:

  • Data-driven decision making is the standard
  • Analytics is central to claims adjustment, underwriting, and pricing processes
  • Analytics drive the entire business, functions are better integrated, and organizational silos no longer exist

The transformation is also dependent on having the right technology in place in order to begin to get buy-in and build momentum as a strategic vision for the organization is implemented. As a McKinsey Quarterly article puts it, companies must begin to build a foundation which enables change. “People have been talking about data-driven cultures for a long time, but what it takes to create one is changing as a result of the new tools available. Companies have a wider set of options to spur analytics engagement among critical employees.” For carriers still looking to move off of core legacy systems that struggle with modern requirements, even starting down the path to becoming an analytics-based insurer may seem out of reach. read more