Claim intake management is a crucial part of every insurance business. It is not a one-size-fits-all type of service. Starting with an in-depth analysis of the first notice of loss goals (FNOL), and current intake processes ensures development of a suitable custom workflow. Using well established rules to ensure accuracy, to minimize call times (ASA), and to reduce follow-up calls, is critical to a successful claim intake operation. Without accurate claim intake, claim management dissolves.
There are 7 key steps to successful claim intake and claim management. These include:
1. Rolling out quickly with a best practices workflow for a complete, logically organized report. Organization is key to maintaining responsive claims management.
2. Offering a wealth of reporting options including telephone, e-mail, fax, Internet, and even electronic file submission is imperative. Each option offered increases the likelihood of successful communication. Redundancies further reduce the number of errors and misfiled claims.
3. Entering notices directly into in-house claims management applications, allowing for additional reporting, tracking, forms management, and dissemination capabilities.
4. Responding quickly to critical incidents. Quick response reduces liability, enhances organization, and mitigates egregious loss. Customized plans specify the data collected, format of reports, detailed recipient notification, and escalation procedures.
5. Ensuring correct routing of claims with rules-driven policies and claim office assignment.
6. Increasing accuracy, consistency, and efficiency by providing policyholder, location, distribution, carrier, and employee demographic data to populate notices at intake. The more information on file, the less likely a claim will be mismanaged or lost.
7. Customizing list options with job titles, department codes, medical coding, PPO providers, and more.
While ensuring accuracy is important, a cost effective claim intake operation is also crucial to any business. They are, or at least should be, one and the same. Intelligent, cost-effective incident reporting management is dependent upon capturing accurate information, the first time an incident occurs, and wherever and whenever an incident occurs. Intake specialists using a best practices workflow are necessary to deliver seamless first notice of loss, whether in-house or outsourced.
Entering notices via the internet, providing medical coding, duplicate checking, quality assurance reviews and notice completion in addition to streamlined and skilled services distinguishes disorganized and unprepared businesses from those ready to lead. Without cost-effective and well-organized claims management solutions, organizations waste valuable resources that can ultimately lead to their demise. Leveraging these 7 key steps is the surest way to enhance claim intake accuracy and all the benefits that come with it.
