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6 Benefits of Claims Administration Software for Public Entities

Insurance claims are costly, complex transactions involving multiple parties, systems, and regulatory concerns. One of the challenges of claims administration arises from the back-and-forth involved for all parties. Processing claims is time consuming.

The margin of error when it comes to claims administration can be vast, especially when administration is conducted in a series of spreadsheets, working across multiple departments and with multiple entities needing to sign off. When it comes to completing even a simple form, one small error can lead to a claim denial.

Claims administrators often struggle to keep track of claims and, therefore, monitoring every regulatory change to ensure compliance with claims filing is another drain on resources. When the rules change — which they often do — it’s even more complicated. A recent Deloitte survey notes that regulatory challenges will continue to mount in 2021, those pandemic-related and otherwise,[1] which means claims administrators face another uphill battle for their time. Increased regulations = more time spent on claims administration.

From a business perspective, it’s important to find ways to manage costs while improving service and outcomes. At the same time, claims administration teams should be focusing on higher-value initiatives, not on paperwork.

There is a better way. And since claimants tend to prefer to monitor their claims online rather than make several calls and emails until they can get a real status report, claims managers, administrators and adjusters will want to consider migrating their claims administration process and claimant interface to a digital platform.

6 Benefits of Claims Administration Software

The best way to put claims managers and adjusters back on those important initiatives is to streamline workflows whenever possible. Here’s how claims administration software can transform the process:

  • Manage documents and information: The world of claims is known for its dedication to paper documents, bills, forms and correspondence. Unfortunately, when that information is available in a filing cabinet, it can be hard to find the single piece of paper with the right information. But technology changes everything – suddenly, anything is accessible instantly through a simple search. 
  • Accelerate workflow. Insurance claims are costly and complicated. They involve multiple parties, systems and regulators, and claims administrators and adjusters often struggle to keep everything organized and moving forward. With claims administration software, however, data is more accessible, regulatory issues become clearer, advanced analytics and reporting options are readily available, and other inefficiencies are reduced to free up the adjusters’ time for other tasks. 
  • Identify “jumper” claims early: Not all claims are created equal. But when claims come into the office, they sometimes appear that way at the beginning. Artificial Intelligence (AI) and predictive analytics, on the other hand, can help you identify from the outset whether a claim will be especially high cost. This can lead to faster, targeted methods for managing that cost, improving performance for return to work, medical management, reserving and risk assessment. 
  • Stay up-to-date:You aren’t a lawyer, and you may not have one (or a compliance officer) on staff. Staying on top of changes in government regulations is a full-time job by itself, especially since they can change annually. From OSHA and CMS to federal, state and local laws, the system is complicated. Maybe the laws don’t change but the forms do. Maybe only the deadlines change. The good news is an automated system manages all of those updates and ensures you’re reporting when you need to report and to the right addresses.
  • Streamline administrative tasks: The process of initiating and resolving a claim generates a huge amount of content, which includes correspondence, document images, meeting notes and assignments, among other things. Claims managers and adjusters spend a huge amount of time selecting and sharing this content. While sharing the information is critical, it shouldn’t become the focus of the organization. Outsourcing these tasks to an automated system is a great way to take the pressure off. 

  • Improve employee productivity: When you allow the technology to take care of repetitive, time-consuming tasks, such as automatically filling out identifying information or wages, not to mention the self-service platforms that allow consumers to begin claims on their own, you leave claims managers and adjusters able to spend less time on administrative tasks and more time on initiatives that can better serve your organization, such as getting people the medical care they need or helping them return to work more quickly.

Case Study: The County of Los Angeles

The County of Los Angeles wanted to replace several existing systems (including two claims administration systems and a risk management system) with a single technology solution. The final product integrated a variety of tasks into a single system, including:

  • Risk management
  • Claims administration
  • Disability and leave management
  • Corrective action plans
  • Legal case management

With more than 1500 users on the new claims platform, the County is able to automate numerous processes into a single technology solution, streamlining what used to be cumbersome and complicated into a simple process designed to focus on the customer. Register for our upcoming session with LA County, click the image below!

Next Steps 

Don’t be caught unaware when regulations change. Accelerating your claims administration program with intuitive software will provide claimants with the claims experience they demand – and can help free up your managers and adjusters to focus on what’s really important simultaneously. For more information on this topic, please reach out to Leslie Sargent.

 

claims admin webinar

[1]https://www2.deloitte.com/us/en/insights/industry/financial-services/financial-services-industry-outlooks/insurance-industry-outlook.html

Mar 25, 2021

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