Category: TPAs

How to create a successful and sustainable near miss culture

The importance of establishing a near miss culture is clear. The OSHA and National Safety Council Alliance, a cooperative program, puts it this way: “History has shown repeatedly that most loss producing events (incidents), both serious and catastrophic, were preceded by warnings or near miss incidents. Recognizing and reporting near miss incidents can significantly improve worker safety and enhance an organization’s safety culture.” Effective near miss programs can prevent more serious incidents from occurring.

A previous post highlights some of the challenges surrounding this issue. Fear of reprisal or embarrassment, difficulty in the reporting process, and a sense of futility if reports don’t result in tangible changes. Each challenge presents obstacles when trying to establish a near miss culture.

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Timing is thingevery—How rushing leads to embarrassing errors

The pressure to do more with less is constant. But delaying an honest evaluation of your risk management information system (RMIS), while an understandable temptation, can lead to compressed timelines, rushed decisions, cost overruns, and additional grey hair.

Industry consolidation is forcing changes both good and bad. Regardless of whether you elect to stay with your current system or make a move, the worst-case scenario is to find yourself boxed in because you ran out of time.

There are a few critical factors a risk manager should take into account to ensure they are in the driver’s seat. Your time is limited, but your options don’t have to be.

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Elevate to better outcomes: How the happiest clients in the business are solving real-world problems with Origami Risk

A flexible, intuitive interface. Software expertise combined with insurance and risk experience. A collaborative approach to implementation that’s different by design. When selecting a Risk Management Information System (RMIS) that meets your needs, each of these elements is important, but in today’s market, these are baseline requirements. The critical factor influencing the choice of a system should be the answer to the following question: Will this technology drive meaningful business results?

Measurable outcomes are what really matter. The right RMIS must prove capable of contributing to your team’s ability to more efficiently analyze risk and insurance data, prevent losses, control claim costs, streamline renewals, and reduce your organization’s total cost of risk. If it cannot, what’s the point?

For some examples of the impact that partnering with Origami Risk has had on the business results of a few of our clients, please read on.

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Boosting Productivity by Avoiding Interruptions

“Suppose each time you ran low on an item in your kitchen—olive oil, bananas, napkins—your instinctive response was to drop everything and race to the store. How much time would you lose? How much money would you squander on gas? What would happen to your productivity?”

That’s the hypothetical scenario that Ron Friedman, a psychologist and author of The Best Place to Work: The Art and Science of Creating an Extraordinary Workplace, introduces in a Harvard Business Review article examining the “cognitive price” of interrupting a task that requires dedicated focus.

“We all recognize the inefficiency of this approach,” writes Friedman. “And yet surprisingly, we often work in ways that are equally wasteful.” read more

Improving adjuster efficiency and accuracy with an integrated forms solution

A recently published, comprehensive workers’ compensation benchmarking study, found that claim costs make up around 80 percent of most claims organizations’ expenses. According to the study’s authors, budget reductions and heightened scrutiny of operational expenses that come as a result mean that claims organizations should “take a close look at what claim activities and best practices drive optimal outcomes.”

Ensuring that paper-intensive, inefficient, and error-prone processes are eliminated is critical. For many claims organizations, this means scrutinizing their workers’ compensation compliance and reporting processes. More specifically, it means finding a solution that reduces the amount of time adjusters spend:

  • Tracking down the correct version of state forms
  • Rekeying data previously entered in the claims management system into forms
  • Correcting errors that result from manual entry of claim details

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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

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.

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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

The high costs of not automating claims reporting

A major study by Accenture spanning 15 years of research compiled across more than 70,000 claims reached a troubling conclusion. Nearly half of an adjuster’s day is lost to low value, non-core administrative work. What makes up a large portion of that waste? In a word, paperwork.

Managing the completion and submission of required forms for each claim—from locating the latest version of a required document, to rekeying claim data into multiple forms and letters—is a key driver. To make matters worse, submitting the wrong forms (or omitting required data) can lead to substantial fines. These fines, however, are not the only costs created by relying on a manual claims reporting process.

The Hidden Costs of a Manual Process

There are three financial impacts from a manual process that are often overlooked:

  • The cost of finding data
  • The cost of bad data
  • The cost of data silos

Together, these hidden costs can be a substantial hit on any claims operation. read more