“We utilize Actec 24/7 first notice reporting services as a key component of the overall cost containment program for a large West Coast public entity. Actec has set the gold standard of quality, flexibility, and technical expertise during the last five years with this client. Actec’s ability to deliver the details of each first notice encounter in a timely, accurate, and highly customized fashion enables our client to quickly assess and assign resources to
incidents efficiently and rapidly. The Actec team is made up of true professionals with a high degree of focus and expertise in their niche industry and a true ‘can do’ attitude and aptitude with in comes to technical integrations and custom business requirements.” – Regional Vice President, Fortune 500 Business Process and IT Services Company
Author: Andrew
What is Full-Cycle Claim and Incident Reporting?
Full cycle claim reporting refers to a comprehensive approach to claims and incident reporting. In some instances, full-cycle claim and incident reporting is also referred to as claims intake and reporting, or even within the general context of first notice of loss (FNOL). The concept is fairly simple; an individual has experienced a loss, theft or damage and needs to reports the specifics to their insurance carrier, third party administrator or self insured organization. It is, of course, important that this intake is professionally handled, promptly addressed and accurately recorded. The intake is extremely important to ensure the resulting claim is accurately reported. Full-cycle claim and incident reporting refers to a comprehensive, one stop approach to this situation. Key elements of a full-cycle solution include:
• Companies can report all incidents to a single claim reporting service
• Claims and incident reporting are fully integrated into the system
• All the information needed for processing is completed on the first report
• Workflow changes can be easily to accommodated to meet new requirements
• There are accurate metrics to determine the actual cost of claim and incident reporting
With first notice of loss, it is important to close claims quickly and manage risk at all levels of the organization. FNOL intake specialists should be available 24/7,365 days a year, to ensure accurate and timely intake whenever an incident occurs and to handle after-hours incidents and overflow. It is also an opportunity for companies to demonstrate their commitment to employees, by ensuring employees receive rapid and professional response, during what is likely to be a very stressful time, namely the reporting of a loss or theft. Creating a full-cycle claim and incident reporting system to respond, monitor and measure the FNOL process is a key component in success in this complex scenario. Many companies outsource their first notice of loss to a full cycle claims and incident reporting specialist, particularly when the consider the challenge of a 24/7, 365 day a year schedule.
Read more: http://www.articlesbase.com/outsourcing-articles/what-is-full-cycle-claim-and-incident-reporting-3698144.html#ixzz1692j4VAK
STATE OF CALIFORNIA RELEASES (FROI) First report of injury state filing statistics for 1 year period 9/2009 to 9/2010
The state of California recently released statistics to all companies filing Workers Compensation(FROI). Actec had a success rate of 99.1% of all reports submitted were accepted by the state on the first submission.
The industry average for the 1 year period was 77.4% acceptance on first submission.
Actec works diligently to make sure your reports are filed timely and accurately thus avoiding re-filing, and potential fines. If you are not using Actec for state FROI filings feel free to call Paul Neleman at 770-916-6847.
What is First Notice Of Loss And Why Is It Important To Both Policy Holders And Insurers?
Most people and companies are often unaware that when they first contact their insurance provider to report theft, loss or damage that they are actually contacting a first notice of loss (FNOL) call center. FNOL call centers typically operate 365 days a year, round the clock, ensuring policy holders can easily report a loss, and further, that the respective insurance companies receive timely and accurate claim loss data.
First notice of loss operations are sometimes staffed internally, but more frequently these days, the operations are outsourced to a specialist. As one can imagine with any 24/7 by 365 day a year operation, staffing, training and accurate claims intake are challenging for any organization. There are different types of vendors which offer solutions for FNOL, some offer software, others offer a comprehensive call center based on a proprietary application, and still others customize their call center operation to accommodate any platform. These are platform agnostic vendors who claim to work with insurance companies’ existing platforms.
Why is first notice of loss important to both policy holders and insurance companies? Obviously the key function of a notice of loss is to alert the insurance entity as to the theft or destruction of something which is covered under the terms of the policy. In some cases, notification will precede the filing of a formal claim. In certain circumstances, the insured may contact a FNOL representative and follow specific rules of engagement relating to the policy parameters. This is happens often when a provider underwrites different types of insurance coverage and uses a specific format for each type of policy offered to consumers. Herein lies the challenge for many insurers, and the frustration for many of those insured, as policy specifics dictate both the necessary information intake, and the resulting claims processing process. In many cases, speed is of the essence. For example, theft relating to jewelry would require very specific loss notification, and further, rapid notification to the authorities and insurance provider can help result in improved odds of recovery.
First notice of loss has also been undergoing a metamorphosis offering insurers an opportunity to demonstrate their relative professionalism at a time where their policy holders are likely upset and under stress. This is an optimum time, regardless of whether the call center is in house or outsourced to demonstrate a customer centric attitude increasing customer satisfaction and loyalty. Thus, first notice of loss (FNOL) is a critical component of client satisfaction and customer retention.
FNOL Intake Specialists are key to Closing Claims Quickly
Close claims quickly and manage risk at all levels of your organization with Actec’s Full-Cycle Claim and Incident Reporting Solutions. Actec FNOL Intake Specialists are available 24/7,365 days a year to be there when incident occur and to handle after-hours incidents and overflow. Actec is changing the rules of claim and incident reporting management with Claim and Incident Reporting solutions that improve productivity and reduce costs for commercial and personal insurance carriers, self-insured companies, third party administrators, and managed care organizations. Our highly customizable claim and incident reporting approach moves beyond just transferring information from policyholders to designated stakeholders to provide you with total information management.
Proper Claim and Incident Reporting is Critical
Proper claim and incident reporting is critical. When an accident occurs, it is important that all information is gathered and processed correctly – the first time. If not, this will slow the reporting process. Slow reporting then leads to slow claim payment and repairs.
Knowing what information is necessary and how to obtain it are paramount. Most business owners are not claim management experts, and although their intentions are good, they do not possess the experience needed to build a complete claim and incident report. This causes a lag in claim processing, leading to a delayed payment.
Do not let a failure to capture all relevant claim information slow down your business.
Case Study: After-hours, holiday and overflow backup
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.
Full Cycle Claim Reporting
When the first notice intake and dissemination process is handled correctly, you can focus on what you do best. Full-cycle reporting adapts to your needs, differentiates your service level, and increases your productivity. It’s structured, yet flexible; professional yet personal; thorough, yet efficient. Discover how full-cycle reporting can help your business.
Workers Comp & Disability Expo
Actec will be attending the National Workers’ Compensation and Disability Conference and Expo November 10-12, 2010 in Las Vegas. Please come by and visit our booth #307.
Are you paying people to sit around waiting for the next call to come in?
Are you paying people to sit around waiting for the next call to come in? Outsourcing to a call center will maximize efficiencies in your operation. Keep your call center open only when your most efficient and use an outsource vendor to pick up calls when you are least efficient. Outsourcing to a call center during times of low occupancy will show up in the bottom line.