Tag: Claims Administration

In a RMIS, the details matter

When choosing a risk management information system (RMIS) or making a RMIS switch, the process of assessing systems sometimes feels like comparing apples to apples. As important as the big functionalities are, organizations would do well to look at the more granular details—details that, however simple they may seem, address their organization’s very specific needs, while also saving time and preventing mental fatigue.

As a Risk Management Monitor article says, “An effective relationship starts with knowing the specific requirements of your enterprise and setting relevant priorities” and then checking how closely your RMIS provider can match them.

Why the little things matter

The workforce today puts in longer hours, more days a week than ever before. But employees aren’t spending all of that time tackling more projects and setting more goals, as one might expect. The 2018 survey Companies Are Overlooking a Primary Area for Growth and Efficiency: Their Managers found that 36% of company managers spend 3 to 4 hours per day on administrative tasks. An employee who spends an hour manually entering data or emailing colleagues about upcoming tasks is using time that could be better spent on more valuable activities like interacting with clients and improving product offerings.

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Make automation matter

It’s not exactly a secret: Regardless of size or industry, every organization stands to benefit from using automation technology to cut down on repetitive, time-consuming administrative tasks. More than simply speeding up a process or getting people to work faster, automating administrative tasks yields value by freeing up employees to focus on the aspects of their job that really matter and provide value.

Automation is wonderful. Except when it isn’t.

As covered in Behind the Hype of Robotic Process Automation (RPA), businesses can run into issues by rushing to reduce costs and improve productivity through automating processes without first evaluating their effectiveness and necessity. The benefits of automating repeatable, administrative tasks can also be lost if automation technology is too difficult to use. The result? Time that could be used performing more high-value activities winds up spent managing software.

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How to prepare for 2019 data breach trends

Data Breach Today offers predictions in What’s Ahead for Health Data Privacy, Security in 2019? While the article focuses primarily on health data, a few key trends apply more broadly and are likely to resonate with all types of organizations.

Prediction: Disruption from regulatory changes is likely

Rebecca Herold, author of 19 books on information security and CEO of The Privacy Professor consultancy, begins the list of predictions by examining the potential for agency updates to HIPAA. “Based on continued pressure from local, state and federal government agencies, law enforcement, researchers and others to ease the sharing of patient and mental health data by removing the need to obtain patient consent, I expect to see OCR issue proposed HIPAA updates,” she notes.

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What does it mean for you if Amazon offers claims management?

One of the Claims Journal’s most popular articles of 2018 covered the Altus report that investigated the possibility of Amazon entering the claims management sector. The fact that Amazon tried to poach employees from Lemonade and recruit for a new product manager position certainly provided enough circumstantial evidence to fire up the rumor mill.

The report highlights some of the advantages Amazon brings to the table. The customer-facing infrastructure — from Alexa and Echo devices to an online juggernaut offering an expansive consumer marketplace and digital media center — is unlike anything currently in the insurance space. In addition, Amazon Home Services, which offers on-demand repairs and potential assistance with installing large replacement goods; its array of supported smart home devices; and its direct access to customer purchase history make the company poised to completely transform the claims management process.
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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

Lay the foundation for a strategic approach to claims management

When it comes to the ability to manage risk and losses, risk managers often face the challenges that come with claims data that is spread across multiple systems and spreadsheets. At the same time, they’re being asked to do more with less. In a previous post, we looked at ways an integrated claims management solution—one that includes multiple integration and workflow automation options—can transform claims administration processes. But you don’t have to be a self-administered organization to benefit from claims management functionality in a RMIS. The following features are just a few examples how such a solution can help you consolidate all of your organization’s claims data in a single system, streamline workflow processes, and perform analysis that contributes to more informed decision making and improved claim outcomes. 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

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