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:
Tag: claim intake specialists
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.
First Report of Injury Forms and the Importance of Timely Response
FROI, or first report of injury, is a critical component to compliance with workers compensation 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.