Ventiv Technology

The Essential Guide to Claims Technology in a Changing Environment 9 C H A P T E R 3 : A N A LY T I C S A N D R E P O R T I N G Take Control of Your Claims Claims are complex. If not managed effectively, claims can be costly and time-consuming to an organization. Unnecessary medical treatments, fraud, and underlying medical conditions are just a few of the warning signs to look out for in a claim. Adjusters, therefore, need to quickly analyze large amounts of historical data to accurately pinpoint and investigate each claim accordingly. Early identification and intervention of "jumper" claims through analytic tools can ensure organizations remain proactive and meet the needs of each client while delivering a cost-effective operation. Robust claim systems that allow for customized reporting and dashboard configuration, in addition to consumption of large amounts of historical data, can help adjusters engage in early intervention, formulate accurate reserves, and manage more cases. Ultimately, this leads to quicker and more accurate decisions, reducing the exposure of your claims organization. More Efficient, Greater Insight, Better Results Highly-customized reports and dashboards empower adjusters to analyze large amounts of historical data to help claim organizations contain costs, optimize resources, and improve efficiency across the board. Data needs to be captured throughout the life of a claim, from the initial injury report right through to settlement. Claims systems should enable adjusters to quickly upload, retrieve, retain, email, and print associated files. There are often multiple documents and records linked to a claim. That's why Ventiv Claims, for example, is designed to be configurable, which means adjusters can deal with data and records in an efficient manner that is best suited for each claim organization. Claim system tools can change the way adjusters handle claims. Ad-hoc queries, customizable reports, graphs, charts, and especially the enhanced intuitive dashboards allow adjusters to reduce time wasted on data analysis and instead focus on outcomes and high-quality service. Reporting and Analysis Made Easy Today's analytics and reporting capabilities make claim processing faster, easier, more cost-effective, and more efficient. Indeed, claim organizations should expect better service and significant savings as a result. For example, Ventiv Claims has the following features that improve ease of use as well as outcomes. • An integrated drag-and-drop reporting dashboard enables users to build pages, providing a greater level of customization. • Dynamic and intuitive dashboards enable adjusters to run root-cause analyses; identify claims that may need further investigation; formulate corrective actions; and make recommendations for improved outcomes. • Real-time data feedback ensures compliance is always met as missing or incorrect data can be flagged before it is sent to the jurisdiction. • Track safety improvements. • Trends and changes in productivity are easy to see and understand. • Toolsets can be self-configured easily to reflect industry best practices. Predictive analytics: Coming soon to a claims system near you Advanced analytics tools that empower system users at all levels to perform automated predictive analytics. In a nutshell, predictive analytics lets users ask, based on the data at their disposal, "What will happen?" Until now, analytics at the business-unit level has focused on the "descriptive" ("What happened?") and "diagnostic" ("Why did it happen?") varieties. What's making it possible to deploy predictive analytics in claims-administration systems? Cognitive computing systems (like Ventiv Analytics) bring automated predictive analytics capabilities to the business user. These systems are trained using artificial intelligence (AI) and machine-learning algorithms to detect, predict, infer, and, in some ways, think. To take just one example of how adjusters will be able to use Ventiv Claims with Ventiv Analytics, imagine combining socioeconomic data (like that from the U.S. Census Bureau) with location and claim data in order to better identify potentially fraudulent claims.

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