Tag: Claim Management

FNOL Technology Supports Uninterrupted Operation

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June 6th, 2014

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When leveraging FNOL (first notice of loss) operations, it’s crucial to stay ahead technologically, harnessing all available venues to maximize the client experience. 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 available, allowing regular electronic distribution of reports daily, weekly, monthly, or by custom period to multiple recipients based on level of management within your organization.

VoIP solutions are invaluable in enhancing telephonic intake by quickly connecting intake specialists with policyholder account information. Call switch statistics must be available for management reporting by individual incoming number. With these tools, complete call statistics and all associated time tracking may be summarized and archived down to thirty-minute intervals.

To maintain quality standards, Actec trainers and supervisors monitor daily, listening to live calls and recordings in conjunction with remote observation of FNOL intake. We record all calls, which are stored as .wav files and readily accessible. Using RightFax, we are also able to log and distribute in- and out-bound faxes and e-mails for efficient and fully accountable document management. Thorough, advanced organization is key to achieving FNOL success.

Incident Reporting and Claim Intake Best Practices

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May 28th, 2014

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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.

Catastrophic Incident Reporting

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February 26th, 2014

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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

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February 5th, 2014

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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

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January 10th, 2013

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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

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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.

Claims Management, Organization, and Customization

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May 11th, 2011

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Claim intakeis 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.• Utilize a best practices workflow for a complete, logically organized report.
• Give customers a variety of reporting options like telephone, e-mail, fax, Internet, and even electronic file submission.
• Enter notices directly into your in-house claims management application, seamlessly launched from our contact tracking module, allowing for 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.

Three Articles on Understanding and Leveraging FNOL

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April 25th, 2011

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First Notice of Loss can be crucial to smooth business operation. Understanding the various aspects of FNOL and how to leverage it by different means (such as outsourcing) is crucial to maintaining visibility into company operational and organizational success. Here are three of our recent articles that explore the matter:

  1. What Is First Notice of Loss
  2. FNOL Execution in Inclement Conditions
  3. Outsourcing First Notice of Loss

Our Most Popular FNOL Article

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April 22nd, 2011

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Most people and companies are often unaware that when they first contact their insurance provider to report theft, loss or damage that they are actually contacting a first notice of loss (FNOL) call center. FNOL call centers typically operate 365 days a year, round the clock, ensuring policy holders can easily report a loss, and further, that the respective insurance companies receive timely and accurate claim loss data.  First notice of loss operations are sometimes staffed internally, but more frequently these days, the operations are outsourced to a specialist. As one can imagine with any 24/7 by 365 day a year operation, staffing, training and accurate claims intake are challenging for any organization. There are different types of vendors which offer solutions for FNOL, some offer software, others offer a comprehensive call center based on a proprietary application, and still others customize their call center operation to accommodate any platform. These are platform agnostic vendors who claim to work with insurance companies’ existing platforms. To read more, check out the full article.

Custom Reporting, Inquiries, and FNOL Outsourcing

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April 4th, 2011

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Not all incidents require a claim to be filed. Actec is a primary source for collecting and disseminating any type of critical information, including custom reports, such as sprinkler impairment notices, product recall reports, questionnaires and surveys. Actec also takes care of a variety of inquires and information requests including referrals to PPOs or other vendors or claim office contact information. Routing these high-volume, but low-yield, calls to a dedicated contact center greatly increases the efficiency of your claim management staff. Many different types of claim management, call reception, issue resolution, and resource management can be outsourced to a companies like Actec. And outsourcing claim management, first notice of loss (FNOL) or even just process reports and questionnaires can substantially increase profitability and decrease strain on a company’s central organizational structure.