Category: FROI

First Report of Injury and the Importance of Timely Response

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April 9th, 2014

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FROI, or first report of injury, is a critical component to compliance with workers comp guidelines. Whether or not an employer agrees with an employee, the FROI must be filed. Typically reports are required when an injury causes an employee to miss 5 or more paid workdays, and must be submitted within seven business days of the fifth missed day of work. Each state has its own FROI form, available online, which should be completed in quadruplicate. One copy must go to the state, one must go to the employee, one to the insurer, and it is recommended to keep one for business records.

If a doctor sees the employee, and the employee complains of work-related injury, he or she is also compelled to file a report. Neither report exists to comment on the veracity of the employee or employer, solely to begin a paper trail to ensure that dates, times, and places can be known to as great a specificity as possible when ascertaining the proper course of action. Like FNOL (first notice of loss), the more promptly and accurately FROI forms are completed, the more likely a positive outcome.

EDI Filing – A Vital Component of Claim Management

Posted on

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.

Efficiently Manage Your Risks with Incident Reporting Services

Posted on

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.

After hours, Overflow and Call Center Closure coverage for FNOL

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December 7th, 2011

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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.

7 Key Terms in the Field of First Notice of Loss

Posted on

March 2nd, 2011

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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.

  1. 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.
  2. FNOL – Abbreviation for First Notice of Loss
  3. First Report of Injury – The initial report of a claim or incident resulting in injury to an employee. A employer practice required by law.
  4. FROI – Abbreviation for First Report of Injury
  5. 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.
  6. 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.
  7. 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.