3 Ways to Improve Claim Intake with Enhanced Call Center Customer Service Practices

Posted on

July 23rd, 2018

shutterstock_138016598 - Copy When customers call their insurance provider to make a claim or discuss an existing claim, the experience isn’t always smooth. After wending their way through a phone tree, customers often just want to speak to a knowledgeable person about their claim. Many of these interactions flow through a call center, which represents a prime opportunity to improve customer retention. The following are several ways to boost customers’ experiences with insurance claim call centers.

Give representatives the tools and training they need. Customer service representatives (CSRs) need to feel confident that they can help any customer that calls. The best way to do this is a blend of quick thinking and expertise with systems and tools of the trade. Skimping on training or forcing representatives to work with outdated tools will yield average results at best, which isn’t a great start for improving customer satisfaction or retention rates.
Foster a positive working environment. Unhappy customers need fast resolutions to keep them from searching for new providers. However, representatives often take the brunt of customers’ anger. Insurers need to make sure they’re taking care of their people as well as their customers. Keeping CSRs in good spirits is vital to processing claims without complaints or delays. Some ideas to boost the office mood include providing snacks in the cafeteria free of charge, raffling off free movie tickets, recognizing performance-based achievements, etc.
Focus on soft skills. Most customers are hesitant to contact call centers because they don’t want to interact with a robotic CSR. Soft skills such as communication, adaptability, conflict resolution, and more are all vital to successful claims resolution. Call simulations or listening to recorded calls can help CSRs learn how to handle angry or upset customers without losing their cool or coming across as unfeeling.

Many insurers focus on closing cases as fast as possible, and they can sometimes lose sight of the customers on the other side of the claims. By investing in a quality claim reporting solution, insurers can spend less time on redundancies and focus their efforts on customer satisfaction, retention, and claims resolution instead. To learn more about claim reporting and outsourcing, contact the experts at Actec.

Avoid These 5 Mistakes for Better Claims Results

Posted on

July 12th, 2018

Andrew

shutterstock_306793247 - Copy Medical coding is a complex process that varies for every procedure, patient, and insurance provider. While no billing department is immune to claim denials, they can avoid several common mistakes to reduce the frequency of them. These include:

Missing information. Claims need to be as specific as possible to avoid a denial. Any missing piece of data can result in a rejection. However, the most common missing details are the date of the medical crisis, the date of onset, or the date of the accident. Avoid this mistake by examining the claim for any missing fields.
Incorrect patient information. Similar to missing data, incorrect patient data can result in a claim denial. The most common examples of incorrect information include misspelled names, inaccurate date of birth, sex, insurance provider, and policy number. Double-checking the patient’s information for accuracy can avoid this kind of claim denial.
Referral required. Some insurance providers require patients to receive a referral or prior authorization before receiving certain medical services. If a primary care doctor sends a patient to another physician for advanced medical tests or specialized treatment, he or she may have to issue a referral while the payer issues a prior authorization. However, receiving prior authorization doesn’t guarantee coverage. If the payer determines the services weren’t medically necessary or if the claim wasn’t filed on time, the payer may still reject it.
Claim filed too late. Continuing with the above, providers must submit claims within a certain window. For Medicare patients, this is of particular importance. The Affordable Care Act reduced the claims submittal period from 15-27 months down to one calendar year. This means from the date of service (the from date on the claim), providers have one year to ensure the payer receives the claim. This means if the provider submits the claim before the end of the calendar year, but the payer receives it after the one year date, the payer can deny it.
Eligibility issues. Insurance terms and coverage change often, so it’s vital to verify eligibility before receiving a service. For example, a patient may be eligible to receive physical therapy following an accident, but only for 12 weeks. If the patient meets their maximum benefit, the payer can deny any claims extending beyond that amount.

Keeping errors to a minimum is critical for successful claims management. If your claims management system is causing several errors and delays, contact the experts at Actec. Our full cycle claim and incident reporting solutions can help you close claims quickly and efficiently.

How to Improve Claims Customer Service

Posted on

June 19th, 2018

Andrew

shutterstock_138016598 - Copy Insurance claim adjusters have a difficult job. They take the brunt of angry client phone calls while managing a workload of dozens if not hundreds of claims at any given time. However, while customer service is part of the job, there are several ways to improve the experience to cut down on the number of complaints. Improving the customer experience isn’t just about resolving complaints either. Twenty percent of customers never complain at all; they let their wallet do the talking and find insurance elsewhere. The following suggestions can help improve the customer’s experience and loyalty.

Follow up often until settlement. Unlike sales calls, customers always want to hear from their claim adjuster. Adjusters should call more often at the onset of a claim when the customer is most upset and in need of guidance. By maintaining frequent contact, the customer isn’t left wondering about the status of their claim or what steps they should take next.
Provide emotional support. One of the most common customer complaints is that their insurance provider doesn’t care about them. While there isn’t enough time in the day for a claim adjuster to provide the amount of emotional support every single customer needs after an accident, showing even a little compassion goes a long way.
Handle complaints with grace. Most of the time, a customer just wants someone to listen to them and apologize for the poor experience. While no adjuster like to listen to criticism, validating a customer’s frustration helps retention rates.
Promote rapid action. Most customer complaints center on delays and lengthy claims processes. However, customers are the root cause for most of these delays. Pointing this out to the customer isn’t likely to yield a positive outcome; instead, the adjuster should encourage the customer to supply necessary documents as soon as possible.

Even when certain tasks are out of the adjusters’ hands, they can influence the outcome of a claim. If your company is struggling with customer retention rates, Actec can help. Contact us to learn more about improving your claims management processes.

How to Improve Claims Management Workflow in 3 Simple Steps

Posted on

June 5th, 2018

Andrew

shutterstock_251707783 sm There are only so many hours in a day, but clients don’t care about their insurer’s workflow problems. They want answers to their questions, rapid resolutions for their claims, and quick payouts for settlements. While insurance companies can’t make the day any longer, they can optimize their existing procedures to improve efficiency. The following are several ways to improve the claims management workflow.

Consolidate and Share Data

Insurers that rely solely on spreadsheets limit their service abilities. When insurance agents and adjusters need to access information about a claim, a massive excel spreadsheet is not the most efficient method. Storing data on several databases also makes it difficult to find all of the relevant information, which slows down the claims resolution process. By storing all data in one location and granting access to all relevant employees, insurers can speed up the claims management cycle.

Prepare for Emergencies

Many businesses operate well enough until they are hit with an emergency. They don’t have the ability to take on the additional work, so their day-to-day tasks sit on the sidelines until they can resolve the problem. This creates a looming disaster, as the sheer volume of backlogged work will swiftly overwhelm employees. If insurance companies consolidate their data as suggested above, adjusters and agents can access the information they need much faster, which better enables them to handle emergency situations.

Look for Trends

When data is easier to access and view, insurers can identify trends much faster. For example, an insurance company may notice certain natural disasters provoke more fraudulent claims than others do. They can then look at those false claims and search for commonalities to red flag similar claims going forward. This can save hours of time otherwise spent working on a case that may or may not be duplicitous.
Resolving bottlenecks in the claims management process doesn’t always have to be complicated. Sometimes, it’s as simple as revamping an existing system to make it work better. If your claims management process is causing headaches, contact the experts at Actec to learn how we can help.

How to Ensure Customer Satisfaction During Insurance Claims

Posted on

May 21st, 2018

Andrew

shutterstock_138016598 - Copy Insurance companies run any number of ads to try to lure new customers; however, retaining customers is just as critical for success. The best way to keep customers loyal is during the claims process. When a customer files a claim, they are often in a vulnerable state. They likely experienced a loss of some kind (i.e. car accident, theft, etc.) and need their insurance company to help them through the process. If their experience is less than satisfactory, customers may begin looking for a new insurer.

First Notice of Loss

First notice of loss (FNOL) is one of the greatest opportunities for insurers to guarantee customer satisfaction. This period of time is when the client is most upset as they are filing a claim right after an accident or loss. Insurers can improve their customers’ satisfaction during this phase by minimizing the amount of effort the client has to put forth. However, while FNOL plays a pivotal role in customer satisfaction, it presents less of an opportunity to improve the overall claim experience.

Acting in the Client’s Best Interest

While many insurers know that FNOL is vital to customer satisfaction, not as many realize that customers place a higher premium on their insurance company acting in their best interest. This part of the claims process can improve customer satisfaction and the overall claims experience. Factors affecting this include:

Managing the client’s expectations
Minimizing or eliminating surprises by supplying the client with solid information
Resolving the client’s issues the first time

Dialing in the Claim

Insurance adjuster can use a few additional approaches to improve the claims process. While they do not do much to improve the customer’s overall satisfaction, they do affect customer retention. These include:

Knowing the client’s personal information
Providing a personalized experience
Finding the client’s preferred contractor for repairs

Insurance companies that focus on the above can improve their customers’ satisfaction as well as their overall claims process. These two factors are vital to improving customer retention. If you’re losing customers to the competition, it may be time to overhaul your claims process. Contact the experts at Actec to learn how we can help.

3 Critical Steps to Improve the Claims Process

Posted on

May 4th, 2018

Andrew

cycle-2019530_1280 Improving the claims management process does more than improve customer satisfaction. It also improves employee efficiency, which allows insurance agents to close more claims on a faster timeline. Whether adjusters have years of experience and are learning new technology or they are new professionals that are used to automated software systems, any insurance agent can benefit from the steps outlined below.

Improving Workflow Processes

Many insurance companies toss around the term best practices, but what they usually mean is common practices. While there are rarely 100% right or wrong answers, agents should incorporate the following into their workflow:

Work outside the claims box. Falling for the idea that all simple fender benders, bicycle incidents, etc. are the same can result in expensive errors. Assuming one accident will play out as a previous similar accident is foolhardy. Agents should approach each claim with a renewed outlook to make sure they do not miss any important details.
Assess and address leaks in the workflow. The saying if it ain’t broke, don’t fix it does not apply in the insurance industry. While a claims process may be working on some level, major inefficiencies (or several minor ones) can add to the amount of time it takes to close the claim. Longer claims processes make for unhappy customers and cost more money in the long run. For example, most claims have an abundance of documents. By assessing how agents collect and file these documents, insurance companies can discover inefficiencies. Once they see the problem, insurers can implement a new process to streamline documentation.
Don’t underestimate processing details. No one stage of the claims management process is more important than another. To put it another way, agents shouldn’t take shortcuts during perceived less important stages of the claim. From pre-claim to post-claim processing, agents need to give the claim their due diligence. This means adjusters need to collaborate and communicate with other relevant agents as well as the customer for a timely resolution with a positive outcome.

Even the best claims management process needs frequent review to ensure it is as efficient as possible. If your claims management process is lacking, Actec can help. Our Full-Cycle Claim and Incident Reporting Solutions can address inefficiencies and improve claims procedures from start to finish. Contact us to learn more.

Do You Know the Best Way to Prevent Car Insurance Fraud?

Posted on

February 19th, 2018

Andrew

impacted car Technology has forever changed how insurers interact with their customers. However, this is not always to the benefit of both parties. With increased online interactions (i.e. quotes, claim submissions, payments, etc.) came a rise in fraud. While banks and retailers have taken the lion’s share of negative press, the auto insurance industry is just as susceptible to cybercrime and fraud.
However, not all fraud affects the auto insurance industry in the same ways. For example, customers commit soft fraud such as lying about how many miles they drive per year or where they store their car. This affects an insurer’s ability to provide accurate quotes. Digital fraud poses a much bigger risk, as it is more likely to affect an insurer’s bottom line. To make matters worse, according to the Coalition Against Insurance Fraud, fraud is mounting. More than 60% of auto insurers confirmed a dramatic increase in fraudulent cases over the past three years.

Balancing Customer Satisfaction with Fraud Protection

Insurance customers, millennials in particular, want seamless interactions with their insurance provider. They also want a variety of communication methods including emails, texts, websites, and online apps. They also want rapid claims resolution so they can receive their money as soon as possible. While this is exceptional for the customer experience, it leaves significant opportunities for cyber criminals to abuse. Solid digital fraud prevention software can help flag common markers of fraud, but that only goes so far.
The greatest challenge facing insurers dealing with fraud is a lack of IT support. Fraud detection software can trigger several false positives, and not every agency has the workforce to sift through which are legitimate and which are fraudulent. As a result, insurers across the nation are increasing their IT budgets to balance the need for superior customer experiences with fraud detection and prevention.
First Notice of Loss (FNOL) represents the greatest opportunity to identify fraud, but not all agencies are utilizing it to its full potential. Fraud investigators rely on claims triaging to notify them of potentially fraudulent claims. However, without a robust trove of data, many adjusters rely on their instincts to forward on potential fraud cases. Improved technology can revamp the claims triaging process to use current and historical data to identify fraud with greater accuracy. This also helps expedite legitimate claims so customers are not held up waiting for payment because of a false positive.
Fraud is not going to stop anytime soon so insurers need to develop strategies to manage it now. To learn more about identifying and reducing fraud risks, contact the experts at Actec today.

Top 3 Insightful Trends for Successful Claims Management

Posted on

January 22nd, 2018

Andrew

shutterstock_138016598 - Copy At the start of every New Year, insurers look for innovative ways to improve their business strategy. However, with a dizzying number of trends flooding the industry, it can be difficult for insurers to ascertain which trends will withstand the test of time and retain their value. Actec understands this predicament, and, as such, put together the following list of essential trends adopted by successful insurance firms.

The Human Touch

Artificial Intelligence (AI) and machine learning are here to stay, but that does not mean insurance providers never have to interact with their customers again. When a customer calls to file their first notice of loss (FNOL) after an accident, they want and need human kindness. While machines are fantastic at processing data, they lack the empathy and finesse required to manage FNOL.

Contextual Connectivity

Insurers need to increase how often they are in contact with their customers, but providers do not want to run the risk of irritating their clientele. While text messaging and email make communication easier than ever, an irritated customer is not an acceptable outcome. Insurers need to make their messages valuable to the customer. For example, a customer requesting information about homeowner’s insurance does not want a barrage of questions and quotes; they want good coverage to protect one of the biggest financial investments of their life. By understanding the context of the customer’s situation, insurance providers can adapt their conversations to help solve the customer’s problem rather than complicate it.

Perfecting Business Operations

Insurers that want to succeed need to make improving business operations a top priority. Accepting the existing state of affairs can lead to complacency, decreased customer satisfaction, and customer turnover. Part of the improvement process should include reexamining and revamping the claims management process. FNOL represents the single greatest opportunity insurers have to deliver superior customer service. If a customer is dissatisfied with their FNOL experience, it is almost impossible to win them over later in the claims management cycle. To learn more about improving your claims management system, contact the experts at Actec today.

Successful Claims Management with Superior FNOL Data

Posted on

December 4th, 2017

Andrew

shutterstock_306793247 - Copy Claims intake specialists cannot optimize the claim intake process without the right information. Missing analytics and failing to use the right tools can result in delays, unnecessary expenses, and frustrations for both the agent and the customer. Harnessing the power of quality data at the onset of a claim is vital to successful claims management. For example, insurers can gain insights from claims data to sort and prioritize claims to ensure they reach the right adjusters.

Gather Data at FNOL

The best time to collect information about a claim is when a customer initiates First Notice of Loss (FNOL). Insurance agents should ask for information about the loss, any injuries or damages that occurred, and encourage customers to collect as many photos of the incident as they can. Mobile apps often allow customers to upload photos, which can be a great help to adjusters.

Funneling Claims

Collecting all the relevant data at the outset of the claim can help insurance companies filter the claim through the right channels. For example, data collected about injuries during FNOL can help adjusters triage the claim. The severity of an injury can determine the route a claim takes. If an insurance agent has to transfer the claim to an injury team later down the line, it may require the new agent to redo work on the claim. This wastes time and money as well as reduces customer satisfaction. Proper data collection can help avoid this issue and get the claim to the correct adjuster from the start.
While early information gathering is key, insurance companies need a full-cycle claim solution for effective claims management. Actec’s claims management solutions include complete FNOL activity tracking to support the claims process. To learn more about using FNOL data for effective claims management, contact us today.

Newer Technology Proving Unpopular for Claim Filing

Posted on

November 17th, 2017

Andrew

shutterstock_138016598 - Copy Technology is booming in several industries, the insurance sector included. However, while customers are more than happy to use mobile apps to buy insurance and review their policies, they hesitate to manage their claims this way. J.D. Power conducted a customer satisfaction study focusing on auto insurance and found only nine percent of customers provided first notice of loss (FNOL) via the internet or mobile app. Surprisingly, younger generations also prefer to provide FNOL by phone as a meager 12% reported their claim via digital means.
This would not be a major cause for concern if not for two facts:

Insurers have invested heavily in technology, and for good reason. The frequency, severity, and cost of claims are on the rise so they need to automate much of the claims process to help manage expenses.
Customer satisfaction with technological FNOL plummeted 16 points. This means that not only are insurers using technology more often, their customers are not happy about it.

However, not all is doom and gloom for insurance apps. Where insurance technology shines is with status updates. While only 16% of insured individuals use a mobile app to receive updates about their claim, their satisfaction is 33 points higher than those who do not. However, this trend skews toward Generation Y and Millennials. Pre-Boomers, for example, do not care for mobile updates. However, as younger generations begin to eclipse all other insured generations, their preferences will take center stage.

What Does This Mean for Insurance Providers?

Customers prefer the human touch when providing FNOL, but technology still has a place in the claims process. To ensure the greatest customer retention and growth, insurers need to tighten up their FNOL process. They also need to train agents on how to maximize customer satisfaction during the FNOL phase of the claim. From there, insurance companies can automate some of the claims processes without disappointing their customers. Actec can help insurers achieve these goals with our custom claim intake solutions. To learn more, contact us today.