Four Ways to Improve Your First Notice of Loss Process

Posted on

August 27th, 2018

shutterstock_306793247 - Copy First notice of loss (FNOL) represents the single greatest opportunity to improve a customer’s satisfaction with their insurer. However, when a customer initiates a claim, they are likely in an emotional state. Filing a claim after an accident, loss, or theft is stressful and customers have high expectations with diminished patience.
A customer’s experience matters for retention and recruitment purposes. If the customer has a negative experience, he or she may find a new insurer as well as tell his or her friends and family to avoid that insurance provider. In fact, customers are 60% more likely to talk about their bad experiences than their positive ones. Because of this, it behooves insurers to fine-tune their FNOL process to ensure their customers have the best claim outcome possible.

How Strong is Your FNOL Process?

The following questions can help insurers assess the strength of their FNOL process:

Can customers start a claim through their smartphone? Technology has caused customer expectations to skyrocket, meaning they want to initiate a claim when they want, how they want, where they want. Customers want the ability to switch their methods of communication from phone conversations to digital interactions. This gives them the freedom to manage their claims from the palm of their hand.
Do customers have several options for how to start a claim? Continuing with the above, customers like a variety of ways to contact their insurer about a new claim. Some prefer to speak to an insurance representative directly while others want to begin the process via digital methods. Forcing customers to initiate a claim in one specific way will frustrate them during an already stressful time.
Can customers receive real-time updates on their claim? Customers don’t like to be left in the dark when it comes to their claim status. They want easy access to updates regarding their claim. This can allow them to stay up to date on verified documents as well as missing information notifications.
Do employees have access to customer data? Allowing a customer to initiate claims from their smartphone is useless if employees don’t have access to that information. This requires customers to provide information multiple times, which frustrates them. If adjusters from various processes can’t connect to FNOL systems, they won’t have the data they need to progress the claim in a timely manner.

A poor FNOL process can cripple retention and recruitment efforts. Addressing the above points can help ensure a positive customer experience and continued customer loyalty. Contact the experts at Actec to learn how we can help you improve your FNOL process.

How to Settle Claims Quickly for Better Customer Satisfaction

Posted on

August 13th, 2018

Andrew

shutterstock_306793247 - Copy Customers and insurers both want rapid resolution for claims. However, insurers have to balance risk and fraud with customer satisfaction, which can result in some delays. The longer a claim sits unresolved, the angrier the customer will become. To help resolve claims without increasing risk, insurers need to put a well-organized claims process in place. Some ways to achieve this include:

Keep claims loads manageable. When claims adjusters take on too many claims at once, they are likely to drop the ball on at least one (if not more) of them. Forming claims into sets or groups based on necessary resources can help expedite the process while keeping the workload practical.
Identify the bottleneck. There are a number of reasons why claims don’t reach settlement. These include disagreements over what insurance will compensate, requests for medical treatment, and overlooked simple requests. These issues can halt a claim so identifying and addressing them can help get it back on track.
Triage claims. The number of unsettled claims can spiral out of control if adjusters don’t manage resolutions appropriately. Adjusters should first focus on claims that are ready for settlement. After that, the next most appropriate claims to settle are the oldest in order to regain those customers’ satisfaction. New claims with complex intricacies should also garner rapid attention as well so that the details don’t get lost over time. Adjusters should avoid working on claims where the claimant is uninterested in settling in favor of the above types of claims. They can always return to those claims after resolving ones that are more straightforward.
Pinpoint ways to improve going forward. Some claims remain unresolved for long periods due to inefficiencies in the claims process. When working claims, try to identify the reasons for this and implement new practices to prevent them in the future. For example, if numerous delays are the result of unanswered medical requests, consider adding a step to check for these requests at regular intervals to make sure no one misses them.

Improving claims processing from first notice of loss to settlement helps improve customer satisfaction and close more claims. If your claims handling processes are causing customer retention issues, Actec can help. Contact us to learn more about our Full-Cycle Claim and Incident Reporting Solutions.

3 Ways to Improve Claim Intake with Enhanced Call Center Customer Service Practices

Posted on

July 23rd, 2018

Andrew

shutterstock_138016598 - Copy When customers call their insurance provider to make a claim or discuss an existing claim, the experience isn’t always smooth. After wending their way through a phone tree, customers often just want to speak to a knowledgeable person about their claim. Many of these interactions flow through a call center, which represents a prime opportunity to improve customer retention. The following are several ways to boost customers’ experiences with insurance claim call centers.

Give representatives the tools and training they need. Customer service representatives (CSRs) need to feel confident that they can help any customer that calls. The best way to do this is a blend of quick thinking and expertise with systems and tools of the trade. Skimping on training or forcing representatives to work with outdated tools will yield average results at best, which isn’t a great start for improving customer satisfaction or retention rates.
Foster a positive working environment. Unhappy customers need fast resolutions to keep them from searching for new providers. However, representatives often take the brunt of customers’ anger. Insurers need to make sure they’re taking care of their people as well as their customers. Keeping CSRs in good spirits is vital to processing claims without complaints or delays. Some ideas to boost the office mood include providing snacks in the cafeteria free of charge, raffling off free movie tickets, recognizing performance-based achievements, etc.
Focus on soft skills. Most customers are hesitant to contact call centers because they don’t want to interact with a robotic CSR. Soft skills such as communication, adaptability, conflict resolution, and more are all vital to successful claims resolution. Call simulations or listening to recorded calls can help CSRs learn how to handle angry or upset customers without losing their cool or coming across as unfeeling.

Many insurers focus on closing cases as fast as possible, and they can sometimes lose sight of the customers on the other side of the claims. By investing in a quality claim reporting solution, insurers can spend less time on redundancies and focus their efforts on customer satisfaction, retention, and claims resolution instead. To learn more about claim reporting and outsourcing, contact the experts at Actec.

Avoid These 5 Mistakes for Better Claims Results

Posted on

July 12th, 2018

Andrew

shutterstock_306793247 - Copy Medical coding is a complex process that varies for every procedure, patient, and insurance provider. While no billing department is immune to claim denials, they can avoid several common mistakes to reduce the frequency of them. These include:

Missing information. Claims need to be as specific as possible to avoid a denial. Any missing piece of data can result in a rejection. However, the most common missing details are the date of the medical crisis, the date of onset, or the date of the accident. Avoid this mistake by examining the claim for any missing fields.
Incorrect patient information. Similar to missing data, incorrect patient data can result in a claim denial. The most common examples of incorrect information include misspelled names, inaccurate date of birth, sex, insurance provider, and policy number. Double-checking the patient’s information for accuracy can avoid this kind of claim denial.
Referral required. Some insurance providers require patients to receive a referral or prior authorization before receiving certain medical services. If a primary care doctor sends a patient to another physician for advanced medical tests or specialized treatment, he or she may have to issue a referral while the payer issues a prior authorization. However, receiving prior authorization doesn’t guarantee coverage. If the payer determines the services weren’t medically necessary or if the claim wasn’t filed on time, the payer may still reject it.
Claim filed too late. Continuing with the above, providers must submit claims within a certain window. For Medicare patients, this is of particular importance. The Affordable Care Act reduced the claims submittal period from 15-27 months down to one calendar year. This means from the date of service (the from date on the claim), providers have one year to ensure the payer receives the claim. This means if the provider submits the claim before the end of the calendar year, but the payer receives it after the one year date, the payer can deny it.
Eligibility issues. Insurance terms and coverage change often, so it’s vital to verify eligibility before receiving a service. For example, a patient may be eligible to receive physical therapy following an accident, but only for 12 weeks. If the patient meets their maximum benefit, the payer can deny any claims extending beyond that amount.

Keeping errors to a minimum is critical for successful claims management. If your claims management system is causing several errors and delays, contact the experts at Actec. Our full cycle claim and incident reporting solutions can help you close claims quickly and efficiently.

How to Improve Claims Management Workflow in 3 Simple Steps

Posted on

June 5th, 2018

Andrew

shutterstock_251707783 sm There are only so many hours in a day, but clients don’t care about their insurer’s workflow problems. They want answers to their questions, rapid resolutions for their claims, and quick payouts for settlements. While insurance companies can’t make the day any longer, they can optimize their existing procedures to improve efficiency. The following are several ways to improve the claims management workflow.

Consolidate and Share Data

Insurers that rely solely on spreadsheets limit their service abilities. When insurance agents and adjusters need to access information about a claim, a massive excel spreadsheet is not the most efficient method. Storing data on several databases also makes it difficult to find all of the relevant information, which slows down the claims resolution process. By storing all data in one location and granting access to all relevant employees, insurers can speed up the claims management cycle.

Prepare for Emergencies

Many businesses operate well enough until they are hit with an emergency. They don’t have the ability to take on the additional work, so their day-to-day tasks sit on the sidelines until they can resolve the problem. This creates a looming disaster, as the sheer volume of backlogged work will swiftly overwhelm employees. If insurance companies consolidate their data as suggested above, adjusters and agents can access the information they need much faster, which better enables them to handle emergency situations.

Look for Trends

When data is easier to access and view, insurers can identify trends much faster. For example, an insurance company may notice certain natural disasters provoke more fraudulent claims than others do. They can then look at those false claims and search for commonalities to red flag similar claims going forward. This can save hours of time otherwise spent working on a case that may or may not be duplicitous.
Resolving bottlenecks in the claims management process doesn’t always have to be complicated. Sometimes, it’s as simple as revamping an existing system to make it work better. If your claims management process is causing headaches, contact the experts at Actec to learn how we can help.

Newer Technology Proving Unpopular for Claim Filing

Posted on

November 17th, 2017

Andrew

shutterstock_138016598 - Copy Technology is booming in several industries, the insurance sector included. However, while customers are more than happy to use mobile apps to buy insurance and review their policies, they hesitate to manage their claims this way. J.D. Power conducted a customer satisfaction study focusing on auto insurance and found only nine percent of customers provided first notice of loss (FNOL) via the internet or mobile app. Surprisingly, younger generations also prefer to provide FNOL by phone as a meager 12% reported their claim via digital means.
This would not be a major cause for concern if not for two facts:

Insurers have invested heavily in technology, and for good reason. The frequency, severity, and cost of claims are on the rise so they need to automate much of the claims process to help manage expenses.
Customer satisfaction with technological FNOL plummeted 16 points. This means that not only are insurers using technology more often, their customers are not happy about it.

However, not all is doom and gloom for insurance apps. Where insurance technology shines is with status updates. While only 16% of insured individuals use a mobile app to receive updates about their claim, their satisfaction is 33 points higher than those who do not. However, this trend skews toward Generation Y and Millennials. Pre-Boomers, for example, do not care for mobile updates. However, as younger generations begin to eclipse all other insured generations, their preferences will take center stage.

What Does This Mean for Insurance Providers?

Customers prefer the human touch when providing FNOL, but technology still has a place in the claims process. To ensure the greatest customer retention and growth, insurers need to tighten up their FNOL process. They also need to train agents on how to maximize customer satisfaction during the FNOL phase of the claim. From there, insurance companies can automate some of the claims processes without disappointing their customers. Actec can help insurers achieve these goals with our custom claim intake solutions. To learn more, contact us today.

Fixing Your First Notice of Loss Process

Posted on

April 11th, 2017

Andrew

smart devices Proactive claims handling is necessary for insurance providers to thrive. A company using a dated paper-based system cannot deliver the level of service customers now expect of their providers. The greatest opportunity insurance carriers have to ensure customer satisfaction is when the customer provides their first notice of loss (FNOL).

FNOL Checklist

Insurance companies should ask the following questions to evaluate their FNOL process:

Do customers have a variety of options for initiating a claim?
Can customers use their smartphone or tablet to initiate a claim?
Can customers upload information via photos?
Do claims representatives have easy access to the data they need to begin the claim?
Do customers receive real-time feedback about their claim?

If an insurance provider cannot answer yes to all of these questions, it is time to overhaul the FNOL process. Failure to provide a certain standard of service can result in customer retention issues.

Putting Customers First

Implementing customer-centric FNOL solutions can reduce complaints as well as help protect a business’ reputation. By focusing on the customer’s experience, businesses provide the following benefits to their policyholders:

Ability to choose the method of FNOL (i.e. through a call center, website, or mobile app)
Enable digital interaction such as text alerts about missing data or uploading photo documentation
Streamlined FNOL submissions to improve the speed of the claim as well as reduce errors

To learn more about customized FNOL solutions that improve customer satisfaction, contact the experts at Actec.

New California State Claim Reporting Requirements Beginning January 1, 2017

Posted on

January 16th, 2017

Andrew

shutterstock_250505056 - Copy The State of California recently amended the California Workers’ Compensation Uniform Statistical Reporting Plan. As of January 1, 2017 it now requires insured employers to report first aid claims to their claims administrators. This does not apply to self-insured organizations that handle claims in-house.
Common types of workers’ compensation claims include:

First Aid Claims, described by the California Labor Code as those involving a single treatment and subsequent observation of a minor injury. This might include antiseptics, bandaging and non-prescription medication.
Incident Only Claims are actually not claims at all, but rather documentation of an incident that does not result in any treatment or disability.
Indemnity Claims involve exposure to indemnity benefits (temporary or permanent disability).
Medical Only Claims involve treatment which exceeds the definition of first aid but does not involve any indemnity exposure. A medical only claim can cover a maximum of 3 days of lost time.

Common practice has been for employers to handle first aid in-house, without documentation. This can save time and have a positive effect on experience mods (and therefore insurance premiums). This change in policy suggests that the State of California now considers these hazards relevant to the overall safety conditions of a workplace. To learn more about how these changes could affect your organization, contact us.

Using Metrics Data to Improve the Claims Process

Posted on

October 10th, 2016

Andrew

shutterstock_251707783 sm Integrating your claims process with technology can provide a number of benefits. Your company can reap most of these benefits through the collection and analysis of data. Simply having the data is not enough, though. Claims management should use the data to improve operations, discover trends, and forecast future claims.

Data to Improve Operations

Metrics can locate areas that need improvement within your claims process. They can also show you where your claims process is performing at its best. You can leverage this information to implement practices that improve the areas where you are weakest. Relevant data include:

Open and close rates
Closing ratios
Age of claim (time it takes from receipt to move it forward in the claims process)
Workloads of employees

Data to Discover Trends

Discovering trends can help your company manage incoming claims. It allows you to take a more aggressive approach to managing certain types of claims based on trend data. It can also allow your company to make changes to reduce the frequency of certain types of claims.

Data for Predictive Modeling

Knowing trends is great, but predicting the outcome is better. While predictive models will never remove the needs for a claims expert, it can help assist and expedite the claims process. For example. Predictive tools can alert the claims representative of a potential fraudulent claim.
Data collection can help you streamline your claims process. To learn more about claims management and custom claims solutions, contact us.

After-Hours Reporting

Posted on

April 27th, 2015

Andrew

An accident can happen at any hour of the day. Knowing the help you need is available outside of normal business hours is essential for your personal sense of security.

Most insurance agencies have a hotline that operates 24/7 with professionals waiting to come to your aide — day or night. Some even offer online reporting for an added convenience. After-hours reporting is a service that’s sometimes outsourced to a third party to free up time for company employees. In addition, there are several benefits to accommodating customers after 5 p.m.:

An accident can be reported at any time. There’s no waiting until the next day.
It creates trust between the victim and the insurance agency.
Benefits are delivered in a timely manner.

Accessible claim reporting is something most customers just expect of their insurance companies. Make sure your company’s system is flexible and designed based on the needs of your clients. For more information on how Actec can help you with an after-hours service, click here.