Mandatory EDI filing may be the biggest headache in Workers’ Comp claim administration. Requirements vary from state to state. Missing or invalid data lead to time-consuming resubmission, filing delays, customer frustration, and even fines. If EDI filing gives you pain, Actec spells relief. Our experts carefully review FROI, SROI and medical bill filings prior to transmission to make sure your filings are done once, Done Right!.
Contact Paul Neleman to learn how Actec can improve your Electronic State Filings
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.
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.
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.
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
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.