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Your Claims Management Can't "Claim" Efficiency

18 Feb 2015 - Mickey Farrance

Claims management touches many systems,

involves multiple stakeholders, and requires constant monitoring. Business Process Management can help make all the pieces fit together seamlessly and efficiently.

1. Claims with incomplete data make it to the agent’s desk

…and the agent spends valuable time chasing down the missing information –chasing after the client or hunting through other data systems to find it. When a client makes a claim, your claims management system should make sure the form is complete. Online forms can be designed to alert the user when information is missing or incorrect, and prompt the user to add or change it.   A BPM solution can prevent improper data – for example, input that does not follow proper naming conventions, is in the wrong format, or in the wrong category – by guiding the user to select from only correct options.  

 

2. Full customer data is not available to agents who need it, when they need it

Even when claims data is complete, there may be other relevant customer information in the system that should be available to the claims handler. Is the customer’s history, the claim history, or any other information about the customer, relevant to the current claim? If the agent doesn’t have access to this information, how would they know?   The claims management system clearly needs to be integrated with other existing systems so agents can access information beyond the current claim.

 

3. Some claims agents are overloaded even while others are available

Accurate prioritization and appropriate routing of claims helps delegate workload evenly. Proper delegation streamlines the entire process by ensuring that each claim is sent to the available individual most qualified to resolve it. 

 

Discover the remaining 7 signs in the document