Ventiv Technology

2 2 | 360º Aon eSolutions [ selecting the right system ] EMPLOYERS strives to provide the best, most responsive claims service. Toward this end, the insurer has always been an early adopter of cutting-edge technology to enhance its claims outcomes and ensure a satisfying customer experience. "Previously, we used a system that was developed in-house," says Christina Ozuna, vice president of western region claims. "But we didn't want to be in the business of software development. We wanted to focus on our core operations, which is to provide superior services and competitively priced products for the benefit of our stakeholders. It was important to find a vendor that would continually improve and invest in its technology to meet our business needs— now and into the future." "We performed an extensive survey of claims systems," says Stephen Festa, senior vice president and chief claims officer. "We wanted a state-of-the-art solution that would optimize efficiency and improve the quality and consistency of claims management. iVOS met our stringent system requirements and provided an integrated, customizable platform to boost productivity, facilitate best practices and enable supervisors to effectively oversee caseloads and compliance." [ front-end efficiencies ] EMPLOYERS has used document imaging for several years. "With iVOS, we can more efficiently intake claims and process claim-related documents," says Ozuna. "Our imaging center handles approximately 25,000 documents each month, including new claim reports, medical reports and attorney correspondence." "As our clients report claims, we're able to enter them more quickly," notes Cris Carlson, project manager. "Our intake has improved from five to seven claims per hour. Our examiners now perform initial reviews sooner, so they can quickly begin the process of delivering benefits and facilitating the injured employee's return to work." Previously, EMPLOYERS used a separate process to barcode and index documents prior to scanning. "Now, we index documents after they're scanned into iVOS," Ozuna says. Since the company eliminated the pre-imaging workflow, it significantly increased the rate at which it could handle electronic documents: [ streamlined workflow ] "With our legacy system, we didn't have the benefit of business rules automation," says Ozuna. "With iVOS, we can configure rules to ensure our staff consistently applies best practices and expert resources. For example, we established a rule to automatically route certain claims—which have a specific accident type and injury type—to nurse case managers. ese referrals enable nurses to manage and facilitate medical treatment at an earlier point in time. eir early intervention is critical to bringing about the best-possible outcomes." "Using the workflow module, we also route tasks to resources outside of claims," says Ozuna. "Previously, if adjusters needed to add a vendor or change a policy, they had to exit the system and send an email request. Now, they can process those requests through a work queue, which streamlines operations and saves time." "We also use the iVOS Central Output Management module," notes Ozuna. "By clicking on 'Distribution,' our adjusters have a centralized method to compile and distribute packets of claims information. Adjusters specify the recipient, as well as the documents to include,—such as a letter, document image, or an entire claim file." "We utilize a mail sorter to stuff and stamp the outgoing claims mail," says Ozuna. "e majority of our packages— approximately 85 percent—are under eight pages, so we're able to automate distribution, which yields tremendous efficiency gains." [ enhanced medical management ] "Nurse case managers provide tremendous value in terms of improving medical costs and outcomes," adds Carlson. "In the past, we managed caseloads through Access and Excel spreadsheets, but it was not very effective. During the implementation, we partnered with the iVOS team to pioneer the case management module, helping to design the screen and business rules. Overall, this module strengthens our medical management capabilities." "We have been able to automate a large portion of our bill payment process. In the past, this process was paper-based," Carlson says. "Staff manually approved bills and mailed them to appropriate bill review companies. ere was no way to easily track authorizations, because approvals were done on paper." "Now, we have an authorization screen; if treatment with a provider is 2 2 | 360º Aon eSolutions scanning has increaseD frOm 400 tO 8,000 Pages inDexing has imPrOveD frOm 60 tO 90 DOcuments nOn-meDical bill Payment has increaseD frOm 11 tO 15 bills Per hOur we spoke with employers' stephen festa, senior vice president and chief claims officer, and other members of the employers claims team about the organization's selection and use of ivos to improve operational efficiency, claims oversight and regulatory compliance.

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