When it comes to claims tracking software, many vendors tout their software as the best. But how do you sort through these assertions to find the right vendor for your organization? What questions should you ask? What features should you prioritize? How can you read between the lines to identify the vendor that will treat you as a long-term partner, not a one-time transaction?
Start your evaluation of claims tracking software by analyzing your company’s own policies, procedures, issues, and pain points. Then consider these five questions as you navigate your options.
Is It Easy to Use?
Claims tracking software should make it easier to adjust claims, not harder. From first report to settlement, the claims process abounds with potential traps and pitfalls that can lengthen the claims adjudication process and increase claim losses and expenses. Don’t let your claims tracking software add to these delays with confusing or complicated interfaces or siloed-off workflows.
Consider whether the solution seems intuitive and easy to learn and use. Is it painless to review claims, enter notes, and approve payments? Will it require a lot of training post-implementation? Will it support the way you work? Will have you have to change the way you adjust claims to support the software – or will the software require expensive retooling to accommodate your adjustment process?
Is It Convenient for Stakeholders?
We’ve all seen the graveyard of software that hasn’t worked out. If it’s not convenient to use—if the automation it offers doesn’t make it easier to accomplish tasks—workarounds soon emerge. When you evaluate your claims management software options, ask whether the software allows claimants to easily report claims. Does it have standardized forms that make claims reporting easy and uniform? How does the solution ensure the accuracy and completeness of claims data?
Also important is to find out if the claims tracking software is scalable to grow and adapt along with your company, industry, and regulatory environment. Is it highly configurable? And can users make simple adjustments themselves without calling in programming help from IT or the vendor.
How Much Does It Automate?
Your claims tracking software should automate as much of your claims process as possible. Automating routine tasks like assignments and follow up not only save time but it makes it easier for adjusters to instantly know the status of a claim.
Will the software automatically schedule payments? Will it free up time so that your adjusters can focus on complex claims that require the human touch? How do reporting and analytics work? Will the solution deliver trend-analysis findings and insights so you can address problems at the earliest stages?
Does It Integrate with Other Essential Systems?
Claims aren’t processed in a vacuum. Before you commit to a solution, determine what data is critical and how it flows inside and outside your company.
Claims tracking software needs to automatically integrate with other key systems in your organization, such as HR, finance, and accounting – as well as with external third parties like carriers.
You’ll also want to ask about data quality – and how much data cleaning will be necessary to bring critical data into the system. Insurance data can be messy. Standard interfaces can be a primary driver to reduce costs and implementation timelines. Understand the full library of standard data interfaces that a vendor provides and how they plan to maintain those standards.
Is the Claims Tracking Software Secure?
In this day and age, data security is paramount. Fines and – even more important – reputational risk from data breaches or other cyber incidents can be crippling to your company.
Thoroughly review your vendor’s security documentation with your internal IT department to understand their measures and who will have access to your data. Focus on each vendor’s security certifications and understand what each protection provides. Do not accept the bare minimum in this area even if it currently meets your own company’s thresholds. Certifications and general data security are constantly evolving, so it’s essential to understand the vendor’s commitment to protect your data both now and in the future.
Claims adjudication is an important vehicle through which you deliver on the promises that your organization has made to claimants and other stakeholders. Your chosen vendor should understand your business, your pain points, and your objectives. And above all, the vendor should have a lengthy and proven track record with risk, claims, and insurance technology.
Choose a vendor who will partner with you throughout implementation and beyond. The vendor should be there to answer your questions regarding functionality, compliance, support, and training. Ask whether the vendor themselves will perform the implementation or if it will be outsourced to a third party you do not know.
Claims tracking software represents a big commitment and a big investment for your organization. Make sure you choose a vendor who is committed to building a partnership with you over the long term.