Actec Systems has been providing claim reporting and other data intake services for many years. The experienced specialists are dedicated to providing solutions to commercial and personal insurance carriers, third-party administrators, FMLA services and more. They follow a complete incident reporting process to ensure that the reports are filed on time and accurately, thus avoiding re-submission and hefty fines. Full-cycle reporting starts with a comprehensive analysis of your needs, goals and the current process of your custom workflow. They ensure accuracy, minimization in call times and reduction of follow-up calls.
With Actec, policyholders can call the moment an incident occurs because Actec Intake Specialists are available 24/7, 365 days a year. They collect and disseminate critical
information such as commercial and personal lines claims, short-term disability and long-term disability claims as well non-claim reports and inquiries. VoIP solutions are utilized for connecting policyholder account information with intake specialists. They complete call statistics and then the associated time tracking is summarized. The trainers and supervisors of this incident reporting company monitor daily calls, listen to live calls along with remote observation of FNOL intake. All calls are stored as .wav files and can be easily accessed.
The incident reporting process does not end at the recording of vital details. These claim reports are required to be converted to actionable information so you can manage risks effectively. Complete incident reports are communicated to key recipients and the urgent reports are immediately flagged as high priority according to your business rules. Actec maintains first reports of injury (FROI) for worker’s compensation and does all state filing
processes of FROI as well as subsequent reports of injury (SROI). This incident reporting company provides you with all the data needed to monitor your performance such as the efficiency of in-house solutions, follow-up calls, filings and distributions and many other vital details.
The incident reporting process is aimed at reducing claims paid out, decreasing administrative costs and reducing overall expenses. The actionable data provides you with a complete overview of your organization for managing risks and
increasing profits. For more information, contact us.
Category: Claim Management
First Notice of Loss for Commercial & Personal Lines
- Don’t Let Your Claims Look Like This – Enlist a Professional
Cost-effective Incident Reporting management is dependent upon capturing accurate information, the first time, whenever an incident occurs. When policyholders call to report a notice, they should be greeted on behalf of your organization by an Intake Specialist, trained to handle worker’s compensation, auto, property, general liability, short-term disability, and long-term disability claims. The Intake Specialist must then capture all relevant data with specialized software, using a best practices workflow. Direct entry of notices into your in-house claims management application via the Internet or secure connection should also be available, as well as Medical Coding, Duplicate Checking, Quality Assurance Reviews and Notice Completion.
After-Hours Reporting Leveraging Specialized Call Centers
Actec specializes in after-hours call centers for claims intake and management. Processing claims in a timely and accurate manner is crucial to effective FNOL. Achieving this requires an internal department trained in such practices, or seamless integration of an outsourced call center. Call centers are often able to provide these services with an increased level of efficiency at a reduced cost. 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.
Top Absence Management & Claim Intake Blogs
Absence management through effective claim intake is a vital service for a wide variety of medium-to-large organizations around the country. These services can be performed in-house or outsourced to a professional dedicated call center, and serve to dramatically enhance efficiency and streamline operations. Learn more about how Absence Management can help you in some of our recent blogs:
FNOL Technology Supports Uninterrupted Operation
When leveraging FNOL (first notice of loss) operations, it’s crucial to stay ahead technologically, harnessing all available venues to maximize the client experience. Data must be integrated across all contact methods, including telephonic, e-mail, fax, and direct web entry, for consolidated reporting and may be filtered by contact method if needed. Individual notices should immediately transmit via automated e-mail or fax to any number of recipients, based on the location, type of report and other criteria. Scheduled summary reports must also available, allowing regular electronic distribution of reports daily, weekly, monthly, or by custom period to multiple recipients based on level of management within your organization.
VoIP solutions are invaluable in enhancing telephonic intake by quickly connecting intake specialists with policyholder account information. Call switch statistics must be available for management reporting by individual incoming number. With these tools, complete call statistics and all associated time tracking may be summarized and archived down to thirty-minute intervals.
To maintain quality standards, Actec trainers and supervisors monitor daily, listening to live calls and recordings in conjunction with remote observation of FNOL intake. We record all calls, which are stored as .wav files and readily accessible. Using RightFax, we are also able to log and distribute in- and out-bound faxes and e-mails for efficient and fully accountable document management. Thorough, advanced organization is key to achieving FNOL success.
Incident Reporting and Claim Intake Best Practices
Cost-effective incident reporting management is dependent upon capturing accurate information, the first time, whenever an incident occurs. When policyholders call to report a notice, they should be greeted on behalf of your organization by an Intake Specialist, trained to handle worker’s compensation, auto, property, general liability, short-term disability, and long-term disability claims. Intake Specialists capture all relevant data using a best practices workflow developed over years of first notice of loss (FNOL) experience. Alternatively, enter notices can be entered directly into your in-house claims management application via the Internet or secure connection. Providing Medical Coding, Duplicate Checking, Quality Assurance Reviews and Notice Completion in addition to streamlined and skilled services keeps Actec Intake Specialists ahead of the curve.
Insight into the Incident Reporting Process
The companies providing full-cycle claim and incident reporting solutions help insurance carriers, self-insured companies, third party administrators and managed care organizations to improve their productivity and reduce costs. Cost-effective insurance
claim reporting management depends upon the efficiency of collecting accurate information for the first time, when the incident occurs. The incident reporting process includes the following steps:
- Analysis of the current process:
The company uses the best practices to make a complete and fully organized report providing various reporting channels such as telephone, e-mail, fax and even electronic file
submission. They respond quickly to critical incidents and prepare customized plans specifying data collected and formats of reports, detailed recipient notification and other vital details.
- Reporting of the incident:
The company’s specialists are available 24/7, 365 days a year for the first notice of loss to handle worker’s compensation, short-term and long-term disability claims. They develop a step-by-step documentation of all records to provide a complete audit trail for every type
of contract received.
- Converting claim reports into actionable information:
After intake of necessary information, the company helps close claims quickly by providing essential services. Some of these services include triage to ensure escalation of critical situations, performing medical coding, duplicate checking to flag matches, quality assurance reviews, follow-up completion of claims and many more. Claim number assignment is also done to track notices from the company according to your rules.
- Expediting completed reports to key recipients:
The incident reporting process does not end at a claim’s closing, but also includes expedition of completed reports to government agencies in formats like EDI, mail, text message, phone or e-mail. The insurance claim reporting services provider maintains all
current state FROI for worker’s compensation and performs all state filing procedures of FROI and subsequent reports of injury and medical bills.
- Managing risk effectively:
Complete and timely incident reporting results in reduced claims paid out, lower claim handling expenses, and decreased costs. A complete overview of your organization helps to identify and manage risks more effectively.
FNOL for Your Business
Different organizations require individualized FNOL solutions. Using a proprietary intake solution in house, we have fewer constraints than a software/ASP vendor, and can implement customizations quickly, as needed rather than on a rigid schedule. We have developed custom browser-based solutions for claim intake, and additional client- or customer-specific questions and instructional scripts can be set up, changed or deleted within minutes by the Account Manager.The many built-in capabilities are primarily profile driven to easily manage the needs of our diverse customer base.
Top Absence Management and Claims Management Blogs
Absence management greatly reduces corporate loss through improved communications and tracking systems. Implementing these systems through a highly trained outsourcing provider allows all parties involved to focus on what they do best. Claims management plays a crucial role in succeeding through absence management. Without a custom-tailored claim intake and management process, salient details are likely to slip through the cracks, defeating the purpose of the program. Learn more about how these solutions play crucial roles in major corporations throughout the world:
Five C's of Full-Cycle Claim Reporting
Full-cycle claim reporting is an indispensable and highly detail-oriented aspect of FNOL and absence management implementation. As with many concepts in the business world, the idea is simple yet the execution requires a high degree of training and precision. Here are the ‘Five C’s’ of full-cycle claim reporting:
- Control – containing costs is what brings the ROI to full-cycle claim reporting solutions
- Configure – customized workflow is what where you find the adaptability to optimize for any claim intake situation
- Capture – effective, efficient, and accurate notice intake is indispensable in achieving timely and successful claims resolution
- Complete – post-notice services, including cast resolution, follow-up, and documentation make the system concretely successful
- Communicate – dissemination and reporting keep everyone on the same page, making full-cycle claim reporting effective for companies of nearly any size