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The Essential Guide to Claims Technology in a Changing Environment

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The Essential Guide to Claims Technology in a Changing Environment 22 C H A P T E R 7 : F I N A N C I A L S How Ventiv Claims Promotes Best Reserving Practices: • All claim information is readily accessible in one location. Dynamic dashboards allow adjusters to see the state of claims at any one time. • Ventiv Claims provides the ability to standardize data entry using radio buttons and checkboxes that enable adjusters to conduct quick and accurate searches. • Advanced analytics reports enable adjusters to spot trends and proactively identify issues to ensure accurate reserves are maintained. • Integrated ISO Claim Search allows users to find essential information on loss histories, claim patterns, and suspect claims. • Advanced notifications can alert adjusters when case reserves need to be updated as soon as information becomes available. • Automatic creation of notes, reserves, form letters, and more based on over 1000 events or conditions. • Integrated document imaging allows claim notes to be attached and easily found. Payment Practices The workers' compensation industry is slowly moving away from manually posting paper checks, bills, and explanations of reimbursement (EOR) to more efficient payment iterations such as electronic funds transfer (EFT). With the introduction of the Patient Protection and Affordable Care Act (PPACA), and with several states already adopting mandatory e-billing practices, paper checks are on the way out. The acceptance of the Internet and the improvement of technology to facilitate secure e-billing practices has seen more organizations move to a paperless environment. While many organizations are adopting EFT, either proactively or via state mandates, there is still a host of organizations that are skeptical of making the move. The impediment to change is the concern new operating models will have financial impacts on expenses and claim costs. However, these concerns prove to be unwarranted, with organizations that have adopted e-billing practices reporting substantial gains in efficiency, improved communication , and lower operating costs as a result of automated processing. More states are pushing for EDI, and with several currently utilizing and benefiting from EFT, it is only a matter of time before the workers' compensation industry embraces the move.

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