Especially for workers comp claims — and especially for companies that use TPAs (third-party administrators) — it’s crucial to have Total Processing Adaptability.
What we mean is that your claims system should let you manage everything you want to manage and to have an optimally flexible relationship with your TPA(s). And it entails the ability of that system to give you the reports you need to enable you to spot trends in your claims experience. Are claims being reported properly? What kinds of claims are prevalent? What types of injuries are most common? What body parts are most likely to be injured? What are the most common complications? What are typical recuperation or rehabilitation times for particular types of injuries?
Beyond that, Total Processing Adaptability means your claims system lets you control the flow of information. We’ve seen setups in which accident reporting goes straight to the TPA because the organization in question doesn’t have the technology to capture accidents. If you’ve got Total Processing Adaptability, you have first-report capability and can route accident reports to TPAs automatically, based on your business rules. The right choice of unbundled software — with no reliance on software provided by a TPA — means your data is yours. If you have multiple TPAs or want to switch TPAs, having your own claims software gives you a layer of protection; that is, an element of risk management that helps normalize your reporting and operations. That ensures one view of your data, regardless of TPA, insulating you from the negative effects of changing TPAs.
When we created Cloud Claims, we knew we wanted to give our customers Total Processing Adaptability. We wanted to ensure a first-class claims experience for claims managed in-house and those managed by a TPA. We wanted to automate workflows to eliminate manual processes. We wanted sending files to TPAs to be as easy as clicking a button. By freeing adjusters from administrative tasks, we wanted to let them concentrate on critical decision-making — and we wanted to supercharge every risk management department’s productivity.
You can’t completely manage the safety of your workers. But you can manage your workers comp claims. With the right TPA and Total Processing Adaptability, you can effectively manage those claims and reduce the costs of the claims that occur.
With the right claims system, you’ll be on your way to more efficiency, better outcomes, and fewer headaches.
