Using Metrics Data to Improve the Claims Process

Posted on

October 10th, 2016


shutterstock_251707783 smIntegrating 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.