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.
Tag: Claim Intake
Popular Incident Reporting & Absence Management Blogs
Incident reporting, absence management, and the claim intake associated with these processes can prove challenging for most larger businesses. Are claims falling through the cracks? Could these lead to unnecessary legal action against your company? Is your organization losing valuable time as a result of a lacking absence management program? To learn how these solutions can improve your bottom line, check out these popular blogs:
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.
Claim Intake and Claims Management Best Practices
Incident reporting must be cost-effective to achieve long-term success in any organization. Cost-effective incident reporting and claims management is dependent upon capturing accurate information in a prompt and well-organized manner. When policyholders report a notice, greeting them professionally is important. Of equal importance, of course, is the professionalism exhibited on the other end of the process – data entry. Trained intake specialists must quickly and accurately ask the right questions and enter the appropriate information into the applicable form using a best practices workflow.
Only through years of first notice of loss (FNOL) experience can claim intake best practices be honed into a streamlined training program. Whether entering notices into a custom application, a standardized application, or your in-house claims management system, capturing the vital details quickly and effectively while maintaining a pleasant demeanor is paramount. Providing medical coding, duplicate checking, quality assurance reviews, and notice completion in addition to streamlined and skilled services keeps costs down and satisfaction up – where they belong.
Catastrophic Incident Reporting
Catastrophic incidents can overwhelm your in-house claim reporting center. Professional call centers can help. For example, our call center is equipped with multiple T-1 and T-3 lines and state-of-the-art VoIP switch technology to handle high volumes. We design custom scripts to capture the information you need and implement them for call center intake, email/fax entry and/or Internet self-service immediately. These attributes are critical to proper catostrphic incident reporting. To learn more, contact us.
After-Hours Reporting and Claims Management
Actec specializes in after-hours claims intake and management. Processing claims in an accurate and timely manner is crucial to effective FNOL. Achieving this requires an internal department trained in such practices, or seamless integration of an outsourced call center. 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.
Principles of Claims Management
Cost-effective claims management is dependent upon capturing accurate information in a prompt and well-organized manner. When policyholders report a notice, greeting them professionally is important. Of equal importance is the professionalism exhibited on the other end of the process – data entry. Trained intake specialists must quickly and accurately ask the right questions and enter the appropriate information into the applicable form using a best practices workflow.
Only through years of first notice of loss (FNOL) experience can claim intake best practices be honed into a streamlined training program. Whether entering notices into a custom application, a standardized application, or your in-house claims management system, capturing the vital details quickly and effectively while maintaining a pleasant demeanor is paramount. Providing medical coding, duplicate checking, quality assurance reviews, and notice completion in addition to streamlined and skilled services keeps costs down and satisfaction up – where they belong.
After hours, Overflow and Call Center Closure coverage for FNOL
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.