Sometimes it’s best to leave a job to the experts. For many companies that may mean outsourcing their marketing department, their accounting, or their facility maintenance. For some, it is a matter of professional claim intake. Whether it’s after-hours or full-time, claim intake outsourcing solutions can drastically improve the productivity profitability of a business while simultaneously increasing customer satisfaction. It’s a situation in which everyone walks away happy because each member of the process is entrusted in the field of his or her expertise. For more on the importance of outsourcing claim intake and FNOL (first notice of loss), check out our article at http://www.articlesbase.com/outsourcing-articles/claim-intake-accuracy-key-to-successful-fnol-execution-4097724.html.
Category: First Notice of Loss
7 Key Terms in the Field of First Notice of Loss
There several important terms when discussing first notice – they may seem esoteric, but their meaning and execution have enhance many businesses and improved the quality of many lives. A positive FNOL interaction is key to successful business operation, but also makes the difference between brightening someone’s day and besmirching it.
- First Notice of Loss – The initial report of a claim or incident resulting in loss of an insured product. A crucial element of insurance coverage.
- FNOL – Abbreviation for First Notice of Loss
- First Report of Injury – The initial report of a claim or incident resulting in injury to an employee. A employer practice required by law.
- FROI – Abbreviation for First Report of Injury
- Claim Management – The conveyance of an insurance-related claim through a system of communication and investigation to ascertain the appropriate compensation. The more adept and timely the claim management, the less shrink for insurers and the higher satisfaction for clients.
- Incident Reporting – A system of documentation for FNOL in which specific details must be thoroughly recorded to ensure proper claim management. Well-trained personnel and a modern, sophisticated incident reporting medium significantly reduce costs due to slow resolution, shrink, and other organizational issues.
- Claim Intake Specialist – Personnel cross-trained in claim management and incident reporting to deliver maximized resolution for client and insurer with minimized investment of time and resources.
There are other component of FNOL , but familiarity with these 7 key terms will illuminate much of our industry and its purpose.
Actec Publishes Article on FNOL in Inclement Conditions
When utilizing FNOL (first notice of loss) operations, it is critical to stay technologically astute, harnessing all available venues to maximize the client experience. This is seldom more apparent than during times of inclement meteorological conditions, which will be explored in a specific case below. 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 be available, allowing regular electronic distribution of reports daily, weekly, monthly, or by custom period to multiple recipients based on level of management within an organization. For more, read the article.
Actec’s FNOL (First Notice of Loss) Claim Management Operating in Inclement Conditions
Although most of Atlanta, including schools, had been shut down for 3 days, Actec’s FNOL was open for business and maintaining top level first notice of loss. Though uncommon for the Atlanta area, strong snowstorms do sometimes occur, crippling the region. Lack of snow removal equipment combined with a storm that dumped nearly 6 inches in less than 3 hours created numerous problems. Here is a breakdown of our claim reporting statistics for Tuesday 1/11/2011. In the face of these conditions, we managed an average answer speed of 33 seconds and an abandon rate of only 2.7%!
Through careful planning by Actec staff, hotel rooms were secured near the FNOL Call Center in Atlanta. Most of the staff had stayed at the hotel since Sunday night and were within shuttle or walking distance. Additionally, we utilized remote employees to ensure maximum customer call reception. Thank you to all our employees who took time away from family to make sure our customers were taken care of.
Configuring Claim Service
Claim intake is not a one-size-fits-all service. Starting with an in-depth analysis of your goals and current process ensures development of a custom workflow that is right for you. It’s critical to use your business rules to ensure accuracy, minimize call times, and reduce follow-up calls.
• Roll out quickly with Actec’s best practices workflow for a complete, logically organized report.
• Give your customers any combination of reporting options: telephone, e-mail, fax, Internet, and even electronic file submission.
• Let Actec enter notices directly into your in-house claims management application, seamlessly launched from our contact tracking module, which allows us to offer additional reporting, tracking, forms management, and dissemination capabilities.
• Respond quickly to critical incidents. Your customized plan specifies the data collected, format of reports, detailed recipient notification, and escalation procedures.
• Ensure correct routing of claims – even verify coverage upfront – with rules-driven policy and claim office assignment.
• Increase accuracy, consistency, and efficiency by providing policyholder, location, distribution, carrier, and employee demographic data to populate notices at intake.
• Customize list options with job titles, department codes, medical coding, PPO providers, and more.
• Send data in any file layout, at any frequency – we handle the rest to minimize your IT resource needs.
Recent Case Study Results: After-Hours Call Center Solution
The Problem:
When a human resources administration service company developed an in-house absence management system, they wanted their previous after-hours call center vendor to enter claioms directly into the new application. The vendor refused, offering instead to develop a custom intake solutiong – at the client’s expense. Without an intake service, the client risked alienating their most important customer accounts. The client came to Actec with two absolute requirements – use the newly developed application and start within nine days.
The Solution:
Each of the client’s accounts – primarily large, Fortune 500 companies – requires special handling, from caller authorization to terminology. This was not provided on the custom intake system. Therefore, training and manual documentation was extremely critical. Within seven days, Actec was trained on the client’s system. Actec then prepared workstation manuals and developed backup intake forms to use during the client’s nightly system maintenance downtime. With an intensive week of training, manual preparation anc connectivity and user setup, we opened our phone lines right on target. The client extended coverage to daytime overflow.
Factors contributing to Actec’s success were:
- Intake Specialists could call on their familiarity with a broad client base in the absence management, FMLA and disability arena – minimizing training time.
- Utilizing extensive experience to provide intake services on client applications.
- Agile organization showed the flexibility required to implement a complex client on a short timeline.
Outsourcing Call Overflow to Maximize Your Call Center Effectiveness
Do you have high ASA’s? Do you have high abandonment rates? Your call center is the first contact that your customers have when problems strike. As with most call centers, there are times when your occupancy rates are at 90% – and no one is available to answer the phone.
You could return the call an hour later or the next day, but that may be too late, and they may have already contacted an attorney. This will increase the cost of your claims dramatically and will simultaneously reduce the effectiveness and level of customer service provided by your organization. This is why many of today’s contact centers employ outsourced call centers staffer with claims professionals to improve the customer experience.
By leveraging a contact center for overflow, nights, weekends and holidays, you will improve the efficiency in your organization by as much as 40% while greatly improving your customer experience. All of which impact the bottom line. Today, many high quality call centers outsource FNOL (First Notice of Loss) for overflow and non-peak times.
Insurers with longer than average cycle times of 14.8 days are rated in the bottom 50% in terms of customer satisfaction. – J.D. Power and Associates
At 80%+ call center occupancy your people are busy, turnover increases due to burnout, customer service is poor, and many calls go unanswered. At 50% occupancy your people have some down time, customer service levels are relatively good, and most calls are answered. At 20% occupancy, almost every call is answered, ASA times are short, customer service is superb; however efficiency is low and the cost per claim is astronomical.
Finding the right outsourced call FNOL solution can allow your call center to improve efficiency and reach maximum effectiveness.
A Recent Client Tesitmonial
“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
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.