Catastrophic incidents can overwhelm your in-house claim reporting center. Professional call centers can help. For example, our call center is equipped with multiple T-1 and T-3 lines and state-of-the-art VoIP switch technology to handle high volumes. We design custom scripts to capture the information you need and implement them for call center intake, email/fax entry and/or Internet self-service immediately. These attributes are critical to proper catostrphic incident reporting. To learn more, contact us.
Author: Andrew
Popular FNOL and Absence Management Blogs
Here at Actec we’ve been blogging about the importance of FNOL and Absence Management Solutions for several years. Here are a few of our most popular recent blogs:
- Overflow and Call Center Closure Preparedness
- Absence Management and Your Business
- After-Hours Reporting and Claims Management
For more on these and other important topics, return to our blog soon!
EDI Filing – A Vital Component of Claim Management
Actec Systems is a leading provider of incident reporting and claim management services in the insurance industry. Having been in this field for many years, they have special expertise in handling workers’ compensation claim administration, short-term and long-term disability claims. The specialists pay special consideration to quick and accurate
capturing of complete information. It is vital that when an incident occurs, complete and critical details are collected. First Notice of Loss is the first report of a claim and forms an important part of your risk management program.
Whether it is commercial and personal lines claims, non-claim reports and inquiries or catastrophic events, Actec Systems is the best source for all of your risk management needs. The intake specialists are available 24/7, 365 days a year so that all vital details can be recorded in First Notice of Loss. The incident notices are then distributed to other
specialists for a quick turn-around. With Actec Systems, you need not worry about the security of the information as their internet self-entry is completely secure. It is integrated with a back-end intake system to ensure there is no loss of functionality. EDI filing is also a part of their services. Claims are submitted via electronic data interchange for the purpose of submission, dissemination and data consolidation.
EDI filing is required to be done by every company and most of them find it difficult to complete the complications involved. With the increasing role of e-commerce, no business can afford to ignore the relevance of the internet in the success of their enterprise. The requirements of EDI filing are different for different states and without the help of professionals; it can be a time-consuming task. Also, missing or invalid data or delays in filing can cause you more fines and troubles. The specialists at Actec Systems
are committed to helping you with all of your EDI filing needs. They carefully review FROI, SROI and medical bill filings before submission to filing to avoid delays and time-consuming submissions. The best practices followed by Actec reduce the need for follow-up. For more details, please browse through www.actec.net.
After-Hours Reporting and Claims Management
Actec specializes in after-hours claims intake and management. Processing claims in an accurate and timely manner is crucial to effective FNOL. Achieving this requires an internal department trained in such practices, or seamless integration of an outsourced call center. Though there are many such solutions, the integration and customization of outsourcing is imperative in reaching the desired outcome. Actec’s many years of experience and highly skilled personnel serve to enhance the efficiency of a business while minimizing risk. To learn more, ask us.
Overflow and Call Center Closure Preparedness
Since July 2004, Actec has provided all after-hours, overflow, holiday and unanticipated closure coverage for a large national insurance company. We currently have nearly 40 phone lines coming in for this client, for each of their claims offices, their primary care center and several large accounts with custom requirements. Calls range from 50 to 500 daily (primarily after-hours). When unexpected volume is directed to Actec, an additional several hundred calls can be offered during a 2-3 hour timeframe with short notice (if any). Our Intake Specialists enter claims real-time via Internet directly into the client’s claim system and take inquiry messages in our own application, which are automatically emailed to the appropriate recipients for prompt handling. This kind of preparedness is crucial in first notice of loss programs.
Outsourcing First Notice of Loss Solutions
First notice of loss presents an area of great opportunities for many medium and large-scale businesses to improve their bottom line. Decreasing risk and shrink while increasing quality of life for employees is a trade-off where everyone wins. But if it sounds too good to be true, that’s because it can be deceptively complex. Understanding the necessary protocols, staffing a facility with trained professionals, and following up on issues around the clock demands a skill set that most companies lack. For precisely this reason, the practice of outsourcing FNOL solutions is both a logical choice and a sound investment. Leveraging purpose-built professional call centers to field first notice of loss claim intake and handling allows businesses of many sizes to become more agile and adaptable.
Absence Management Case Study
When a Human Resources administration service company developed an in-house absence management system last summer, they wanted their current after-hours call center vendor to enter claims directly into the new application. The vendor refused to continue remote entry, offering instead to develop a custom intake solution – at the client’s expense – of their own.
The client came to Actec with two requirements: 1) that Actec use this application and 2) that we start in nine days! With an intensive week of training, manual preparation and connectivity and user setup, we opened our phone lines on target. Each of the accounts, primarily large, Fortune 500 companies, require special handling, from caller authorization to terminology, that is not provided on the intake system, so training and manual documentation was extremely critical.
The client provided on-site training during the week before the Saturday deadline. Actec prepared workstation manuals and developed backup intake forms to use during nightly system maintenance downtime, for subsequent reentry. The client plans to extend coverage to daytime overflow in the near future. Factors contributing to our success were: experience with a broad client base in the absence management, FMLA and disability arena, and organizational agility and flexibility.
Key Terms in FNOL & Absence Management
First notice of loss and absence management programs present a substantial opportunity for organizations to improve efficiency, decrease shrink, and increase the bottom line. The basic concepts of FNOL and absence management are simple enough, but it doesn’t take long to get bogged down in dense terminology and jargon. In this blog we’ll lay out some of the most important terms.
Incident Reporting – The process of transferring data from the initial instance of contact into a working claims document.
Workflow changes – Modifications to documentation and procedure based on new requirements set forth by legislation or corporate shifts in policy.
Intake Specialists – Personnel trained in first notice of loss and incident reporting procedures.
Claims Management – Processing incident reports to resolve necessary documentation, compensation, and other issues arising in the FNOL and absence management process.
Popular FNOL Blogs
First Notice of Loss if an issue that effects the bottom line of companies around the world. Though it is both important and ubiquitous, it is often overlooked or misunderstood. Here are some recent articles that shed light on this important topic:
Absence Management 2013: Terminology
When discussing absence management, it’s important to understand the many nuances relating to these initiatives. Let’s review some definitions which can apply to this growing field:
Disability Programs: Disability programs are narrower in scope than absence management and utilize processes to reduce the cost impact of disability, and provide methodologies to promote optimal recovery and return to work.
Health and Productivity Management: This can be defined as the integration of management, data, and services relating to all aspects of employee health that affect attendance and work performance, and is the broadest umbrella for such programs.
Behavioral Risk Integration: Many employers now utilize behavioral risk management as part of their absence management program to address underlying psychosocial issues that complicate claims or encourage absence. Behavioral health management is considered an integrated, interdisciplinary system of care that approaches individuals, families and communities as a whole and addresses the interactions between psychological, biological, sociocultural and environmental factors.
Workplace Wellness Programs: Workplace wellness can be defined as an organizational program designed to support improved health for all employees. It can include activities like health education, medical screenings, health fairs, weight management, health coaching, newsletters, on-site fitness centers and other wellness oriented educational programs.