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Many organizations use Excel as a claims management solution. Consider that over 1.3 million companies worldwide use Office 365 and can access Excel. Despite its popularity, Excel has many limitations and poses risks as a self-insured organization’s primary claims management tool. Here are reasons why Excel is not a suitable alternative to a database system or claims […]
The role of employers and claimants in the claims process is important, and it begins with the first notice of loss (FNOL). The FNOL is the first content that initiates the insurance claim process. It is the moment the claimant notifies an employer about any damage, loss or injury, before the employer can respond to […]
Claims processing involves a series of steps and coordination between multiple parties from the first notice of loss (FNOL) to claim closure. Many challenges can arise throughout this process that can impact decision-making and cause delays. For example, a lack of access to real-time data can lead to an inaccurate incident report, which can delay […]
On October 11, 2023, the Centers for Medicare and Medicaid Services (CMS) published the long-awaited final rule stating how and when the agency will impose penalties when responsible reporting entities (RREs) fail to comply with Section 111 of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA). The final rule will be applicable on October 11, 2024, and the earliest CMS will […]
Has your organization recognized a need to shift from manual processes? Are you interested in streamlining incident reporting, risk management and claims processing? You may be considering investing in a risk management information system (RMIS). An RMIS consolidates all data related to claims, incidents and insurance policies and stores it in a centralized location. It […]
Cloud computing refers to services delivered via the internet rather than on-site hardware or software. The concept of being able to access programs and data from anywhere, traces back to the 1960s, though the term “cloud computing” was not coined until 1997. Today, cloud computing is a tool commonly used by businesses — including organizations that […]
Key performance indicators (KPIs) are metrics used to evaluate and benchmark performance. Their purpose is to help businesses measure and monitor progress toward set goals. If a company looks at its KPIs and discovers it is not on track to reach a specific target, it can then identify and address inefficiencies. In the claims management […]
Your organization’s risk management information system (RMIS) collects and stores incident data, enabling efficient root cause analysis. It allows your company to make quick, informed decisions and take action to prevent future incidents. While a scalable, customizable and intuitive RMIS can help your company manage risk effectively and reduce claim costs, a limited system can lead to […]
Claims management can be a complex and time-consuming process rife with challenges, from ensuring claim data integrity to maintaining contact with claimants. In addition, self-insured organizations and third-party administrators (TPAs) are under significant pressure to process claims as quickly as possible. Regardless of an organization’s current position, streamlining the claims management process is achievable. Purpose-built […]
Outdated software can pose many risks for businesses that rely on accurate data and efficient processes. Systems that do not keep up with changing technologies inhibit smooth operations and create inefficient workflows. Replacing a claims management system that may already be obsolete creates more opportunities for agile processes in your business. It minimizes work disruption, […]
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