Workers' compensation claims are a perfect example. The electronic intake of claims-related
documentation, combined with workflows that leverage that data, can dramatically impact
the process. Examiners can perform initial reviews faster; adjustors can easily access and
distribute information to third-party administrators, nurse care managers, and independent
medical examiners; and claims supervisors can be proactive by keeping track of statutory
deadlines.
The result? A process that increases efficiency, facilitates the quicker return of the injured
party, and offers the best outcomes for both parties.
Does the claims system integrate seamlessly with other internal or third-party systems?
Does the claims system allow a smooth and secure interchange between other internal
systems including underwriting, legal, and accounting?
5. Analysis and Reporting
Is data analytics a game changer for claims organizations?
Data analytics tools – including artificial
intelligence (AI), robotic process automation
(RPA) and machine learning (ML) – are
beginning to have a huge impact on claims
processing, claims and fraud prevention, and
the customer experience, just to name a few.
State-of-the-art systems deliver operation
and performance reports via pre-built
standard reports and ad hoc analytics tools
that integrate with third-party business
intelligence packages. Most offer robust
reporting and analytics features, including
dashboards with drill-down capabilities,
graphical interfaces, benchmarking, and
activity-based cost reports.
CLAIMS BUYERS GUIDE | 7
Questions to Ask
