Maybe you’ve updated your claims software, and streamlined key processes to be more productive, cut costs, and improve service. Great! Check that off your list, right?
Well … not so fast.
Successful claims management is a journey of continuous improvement, rather than a final destination. Even small tweaks here and there can make a big difference to your bottom line. It’s all about making connections between your systems, your vendors, your people, and your strategies.
Here are 7 ways you can strengthen those connections to improve claims outcomes:
1. Make good use of your claims data. Claims generate a lot of data – and the right technology can tell you what it means. Artificial intelligence combined with big data can help you identify:
- Complex claims that would benefit most from early involvement and an experienced adjuster
- Claims with high fraud potential so those can be quickly referred to an investigator
- Claims with high litigation potential so defense counsel can immediately start building a case
- Claims that need additional medical resources to determine if the current treatment follows best practices
2. Institute a comprehensive task-management system. There are a lot of moving parts with a claim, so diligently record everything you can within the claim file – including adjuster notes, medical diagnosis, reserves, and settlement authority. That way, everyone involved knows exactly what was done and who did it. And if an action isn’t recorded, don’t consider it done.
3. Follow the 24-hour rule. Claims that drag on cost more – and that’s particularly true with workers’ compensation claims. Any lag in response time sends a message to the injured employee that you don’t care. To increase your odds of a good outcome, aim for making initial contact within 24 hours.
4. Have a strong return-to-work program. The longer an employee stays out, the more expensive it is. Establish clear return-to-work policies and guidelines – and apply them consistently across your organization.
5. Know when to bring in outside help. Analytics can help you determine when to bring in outside help to manage work levels, add expertise, or get someone geographically closer to the situation.
6. Make vendors an integral part of your team. Vendors – including attorneys, medical professionals, auto-repair shops, contractors, medical case managers, and TPAs – are an extension of your risk management team, whether you like it or not. Strengthening vitally important relationships can balance workloads, control costs, and drive efficiency. Get to know your vendors personally, establish clear performance expectations – and hold them accountable.
7. Use dashboards extensively. A well-executed dashboard shows you everything you need to assess the health of your claims operation at a glance. Keep your dashboard focused on the six to eight metrics you need to do your job effectively. And if the C-suite calls, you’ll be ready.