Category: Claim Management

Claim Intake and Claims Management Best Practices

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March 5th, 2014

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Incident reporting must be cost-effective to achieve long-term success in any organization. Cost-effective incident reporting and claims management is dependent upon capturing accurate information in a prompt and well-organized manner. When policyholders report a notice, greeting them professionally is important. Of equal importance, of course, is the professionalism exhibited on the other end of the process – data entry. Trained intake specialists must quickly and accurately ask the right questions and enter the appropriate information into the applicable form using a best practices workflow.
Only through years of first notice of loss (FNOL) experience can claim intake best practices be honed into a streamlined training program. Whether entering notices into a custom application, a standardized application, or your in-house claims management system, capturing the vital details quickly and effectively while maintaining a pleasant demeanor is paramount. Providing medical coding, duplicate checking, quality assurance reviews, and notice completion in addition to streamlined and skilled services keeps costs down and satisfaction up – where they belong.

Catastrophic Incident Reporting

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February 26th, 2014

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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.

EDI Filing – A Vital Component of Claim Management

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February 12th, 2014

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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

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February 5th, 2014

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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

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January 9th, 2014

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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

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March 20th, 2013

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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.

Principles of Claims Management

Posted on

January 10th, 2013

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Cost-effective claims management is dependent upon capturing accurate information in a prompt and well-organized manner. When policyholders report a notice, greeting them professionally is important. Of equal importance is the professionalism exhibited on the other end of the process – data entry. Trained intake specialists must quickly and accurately ask the right questions and enter the appropriate information into the applicable form using a best practices workflow.
Only through years of first notice of loss (FNOL) experience can claim intake best practices be honed into a streamlined training program. Whether entering notices into a custom application, a standardized application, or your in-house claims management system, capturing the vital details quickly and effectively while maintaining a pleasant demeanor is paramount. Providing medical coding, duplicate checking, quality assurance reviews, and notice completion in addition to streamlined and skilled services keeps costs down and satisfaction up – where they belong.

Efficiently Manage Your Risks with Incident Reporting Services

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June 27th, 2012

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Actec Systems is a reputable name in the industry for providing efficient incident reporting services to clients. The intake specialists are experienced in handling calls and reporting all vital details at FNOL. The call center employs multiple T-1 and T-3 lines and the most advanced VoIP switch technology so not a single call gets missed. They conduct an in-depth analysis of your goals and design customized scripts to capture the details that you need and then offer your customers various reporting options such as e-mail, fax, internet and electronic file submission. They improve the quality and quantity of the data captured. The specialists at Actec Systems are experienced in designing and implementing highly intuitive workflow driven applications for your business.

The best feature of Actec Systems is that their solutions are customer driven. For effective incident reporting management, they employ the best practices for capturing complete information at the first time. The customized workflows ensure accuracy and reduction in call times. All data is accurately recorded in their proprietary system. The claims reports are then converted into actionable reports so you can start investigations, track activities and manage risks. The complete incident reports are sent to various recipients such as government agencies via EDI, mail, phone, e-mail or other format.

Incident reporting services help reduce the claims paid out, the handling expenses and administrative costs. The litigation costs as well as medical expenses also get reduced. Their clear and accurate details provide you a complete overview and you can easily identify risks and manage them. The benefits of incident reporting management include lowering call handle times and increasing the efficiency of customer services. With Actec services, you can gain a complete view of claims operations through real-time analytics. You will be in a position to conveniently resolve claims faster and gain higher customer satisfaction and loyalty. For more information about Actec Systems, please browse through www.actec.net.