Without enough expert adjusters, many claims departments find themselves overworked and understaffed. Rationalizing investments in more staff can be a slog, especially when budget constraints are tight. At the same time, you have to attract new customers and keep them on your books by meeting their claims expectations. For a third-party administrator (TPA), accomplishing this without sacrificing cost efficiency can be a persistent challenge.
But with a solution that incorporates artificial intelligence, analytics, and configurable workflows, you can enable a small staff to do more in less time—and provide the kinds of claims experiences that keep customers coming back for more.
Enable Customers to Easily Access Your Claims Management Solution
Your claims management software should provide customers with a dedicated portal they can access via a mobile device or computer. With this access, they can grab quick answers to important questions about their claim’s progress and timeline, adjust their claims, and reach out if they need more assistance.
In turn, they can provide answers to the people they’re accountable to, which makes everyone’s day go much smoother.
Use Embedded Compliance Tools
Whether it’s navigating standards for worker’s comp, health insurance, or Form 1099, the compliance landscape can be complex—and even expensive if integrating with multiple third-party services. But you can reduce costs and still meet customer expectations using embedded compliance tools that automatically ensure the claims process meets various requirements.
For example, there are time frames in which you need to process a first report of injury (FROI) or subsequent report of injury (SROI). By processing claims using an automated system that factors in these timeframes, you ensure your clients don’t fall out of compliance with these time-sensitive regulations.
Support Multiple Channels for Claims Communication
You can interact with customers on their terms by supporting a range of communication channels. Instead of forcing them to connect through a method they may find restrictive or cumbersome, you should have a system that supports various channels including email, texting, and mobile app chat.
Not only does this make communication more convenient for your customers, but it also saves them time. They can quickly contact you with whatever channel works best for them and continue their busy day.
Multiple channels also simplify communication with your claimants. For instance, with claims administration software, you can push information easily and quickly through the software’s access portal. This results in fewer phone calls between your clients and file handlers and less confusion and frustration about necessary documents or information.
Use Automation and AI for Smoother, Faster Claims Processing
Thanks to AI and analytics, straight-through processing (STP) is now more feasible than ever—regardless of the size of your staff. These tools can also determine the claim’s severity, estimate reserves, and identify subrogation opportunities.
Each process requires data-based decisions, and an AI-based predictive analytics system can instantly process and analyze applicable data. While a human typically makes the final decision, claim management software helps quickly surface and analyze the data people need to make the right calls.
Your customers then get a smoother claims process, faster payouts, and less anxiety throughout their claims journey.
More Efficient Claims Processing = Lower Internal Costs
A claims management solution also means less time spent on claims and fewer human errors—which translates to lower internal costs.
For example, claims management software automates routine tasks so your employees can complete their work faster. This reduces the chances that you’ll have to pay them extra for overtime work. It also gives your staff more time to focus on revenue-generating activities, such as connecting with new or existing customers and creating awareness around your insurance services.
Automate Your Internal Claims Communication System
It’s easy for miscommunications or minor errors to snowball into significant and frustrating delays. But with a claims management solution, you can get hundreds of pre-configured business rules that automatically provide alerts about litigation dates and other critical claim events.
Instead of worrying about whether your staff knows the next step and when to take it, you can rest assured that they’re always on the right page. Naturally, customers also benefit from faster claims processes, unhampered by the delays resulting from inadequate communication.
Configure Your Claim Management Solution to Suit Your Workflows
With some claims management solutions, what you see is what you get. But when your claims management software allows you to configure its functions to match your workflows, you don’t have to constantly try to jam round pegs into square holes.
For example, suppose only certain people on your team can handle claims that reach a specified value. A customer provides information that considerably escalates the claim’s severity, forcing you to change the assigned adjuster. Figuring out which adjuster, contacting them, and fitting this claim into their schedule could cause a considerable delay, leaving a sour taste in your customer’s mouth.
On the other hand, your claim management software can automatically choose the right adjuster based on the claim’s details. Thanks to this feature, your customer isn’t left tapping their fingers waiting for the process to move forward. There’s little to no delay, and their claim moves forward as expected.
Satisfy and Retain Customers While Saving Money with Ventiv
With Ventiv, you get a solution that gives customers access to claim information, supports multiple communication channels, automates workflows and communications, and empowers you to self-configure your process to match your business needs. These features lift much of the burden off the shoulders of your hardworking staff. As importantly, you get streamlined, automated claims processes that get customers the information and settlements they want, so they keep coming back for more business.
Chat with an expert to see why Ventiv’s Claims Management Solution is the right solution for your organization.
