Claim Reporting Assessment

The Basics

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	:: Solutions Auto Suite Workers’ Comp Integration Property Services Glass+

Innovation First Notice has streamlined the process of information transfers resulting in shorter lag times, reduced expenses, and a better customer experience. The process, in its most basic form, can be boiled down to the intake of the transaction, the acting on the transaction based on a client’s business rules, and the notification of the transaction to all stakeholders.

Intake

Insurance claims and other types of sensitive items can be reported by phone, by fax and online over the Internet. Those reported by phone or fax generally come in to a central call center for entry. This can be a Innovation First Notice call center when the whole process is outsourced, or a client call center when that client prefers to use the First Notice software but have its own CSRs taking the calls. In either case, the transactions are entered by the reps walking through a customized call flow in ClaimCapture.

Acting

ClaimCapture intelligently guides the reporter through the transaction from beginning to end. “Intelligently” because it has all your business rules wired directly to the call flow and can lookup/verify coverages and policies on the fly. On the surface, the result is that a certain answer can trigger new questions and de-activate others. Depending on location, type of reporter, and other criteria, entirely new screens are presented. And based on still other rules and a reporter’s eligibility, whole new functions can be invoked like the ordering of a police report or the referral to a medical specialist.

Notification

When all the information for a given type of call has been successfully collected, ClaimCapture immediately begins notifying everyone who needs to know—in the format they prefer. For a workers’ compensation loss, for example, an XML transmission sends the details of the claim directly into the carrier’s claims management system. The branch gets an email, the state gets its mandatory EDI filing, the employer gets a fax, and the Risk Manager who called in the claim gets a copy of the report sent via US Mail. Who needs to know and how would they like to be told? It’s all configurable with ClaimCapture.

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