Actec Systems has been providing claim reporting and other data intake services for many years. The experienced specialists are dedicated to providing solutions to commercial and personal insurance carriers, third-party administrators, FMLA services and more. They follow a complete incident reporting process to ensure that the reports are filed on time and accurately, thus avoiding re-submission and hefty fines. Full-cycle reporting starts with a comprehensive analysis of your needs, goals and the current process of your custom workflow. They ensure accuracy, minimization in call times and reduction of follow-up calls.
With Actec, policyholders can call the moment an incident occurs because Actec Intake Specialists are available 24/7, 365 days a year. They collect and disseminate critical
information such as commercial and personal lines claims, short-term disability and long-term disability claims as well non-claim reports and inquiries. VoIP solutions are utilized for connecting policyholder account information with intake specialists. They complete call statistics and then the associated time tracking is summarized. The trainers and supervisors of this incident reporting company monitor daily calls, listen to live calls along with remote observation of FNOL intake. All calls are stored as .wav files and can be easily accessed.
The incident reporting process does not end at the recording of vital details. These claim reports are required to be converted to actionable information so you can manage risks effectively. Complete incident reports are communicated to key recipients and the urgent reports are immediately flagged as high priority according to your business rules. Actec maintains first reports of injury (FROI) for worker’s compensation and does all state filing
processes of FROI as well as subsequent reports of injury (SROI). This incident reporting company provides you with all the data needed to monitor your performance such as the efficiency of in-house solutions, follow-up calls, filings and distributions and many other vital details.
The incident reporting process is aimed at reducing claims paid out, decreasing administrative costs and reducing overall expenses. The actionable data provides you with a complete overview of your organization for managing risks and
increasing profits. For more information, contact us.
Category: Outsourced Call Center
Popular FNOL & Absence Management Blogs
First notice of loss and absence management are strategies crucial to optimizing the bottom line for most medium and large businesses. Regardless of your market segment or region of the globe, tracking and controlling absences, injuries, and damages effectively can improve the security and integrity of your business. Such programs can be implemented in-house through outside training and hiring, or via outsourcing to an expert in the field. To learn more about these and related issues, check out a few of our popular blogs:
After-Hours Reporting Leveraging Specialized Call Centers
Actec specializes in after-hours call centers for claims intake and management. Processing claims in a timely and accurate manner is crucial to effective FNOL. Achieving this requires an internal department trained in such practices, or seamless integration of an outsourced call center. Call centers are often able to provide these services with an increased level of efficiency at a reduced cost. Though there are many such solutions, the integration and customization of outsourcing is imperative in reaching the desired outcome. Actec’s many years of experience and highly skilled personnel serve to enhance the efficiency of a business while minimizing risk. To learn more, ask us.
First Notice of Loss Key Terminology
There several important terms when discussing first notice of loss. Though many are unfamiliar with the concept, it stands as a crucial component of many successfully operated large businesses.
- FNOL – Abbreviation for First Notice of Loss, the initial report of a claim or incident resulting in loss of an insured product. A crucial element of insurance coverage.
- FROI – Abbreviation for First Report of Injury, the initial report of a claim or incident resulting in injury to an employee. A employer practice required by law.
- Claim Management – The conveyance of an insurance-related claim through a system of communication and investigation to ascertain the appropriate compensation. The more adept and timely the claim management, the less shrink for insurers and the higher satisfaction for clients.
- Incident Reporting – A system of documentation for FNOL in which specific details must be thoroughly recorded to ensure proper claim management. Well-trained personnel and a modern, sophisticated incident reporting medium significantly reduce costs due to slow resolution, shrink, and other organizational issues.
- Claim Intake Specialist – Personnel cross-trained in claim management and incident reporting to deliver maximized resolution for client and insurer with minimized investment of time and resources.
Numerous other components comprise a comprehensive FNOL program, but familiarity with the basic terms makes it much easier to understand the process of first notice of loss and the benefits of leveraging FNOL in large businesses.
Top Absence Management & Claim Intake Blogs
Absence management through effective claim intake is a vital service for a wide variety of medium-to-large organizations around the country. These services can be performed in-house or outsourced to a professional dedicated call center, and serve to dramatically enhance efficiency and streamline operations. Learn more about how Absence Management can help you in some of our recent blogs:
Catastrophe Reporting: Weathing the Storm
How can your business handle FNOL call volume in the event of a catastrophic incident? Outsourcing all specific-incident calls or general overflow to claim intake professionals will dramatically reduce the likelihood of long wait times, missed claims, and other volume-related issues. High bandwidth technology including fiber optics, VoIP switching, and cloud storage allow for greatly increased call handling efficacy. Further, custom scripts that capture critical information and automatically transfer to a central database for access and reporting will mean that your business is never in the dark. These are a few of the many attributes crucial to expert catastrophic incident reporting. To learn more, contact us.
Insight into the Incident Reporting Process
The companies providing full-cycle claim and incident reporting solutions help insurance carriers, self-insured companies, third party administrators and managed care organizations to improve their productivity and reduce costs. Cost-effective insurance
claim reporting management depends upon the efficiency of collecting accurate information for the first time, when the incident occurs. The incident reporting process includes the following steps:
- Analysis of the current process:
The company uses the best practices to make a complete and fully organized report providing various reporting channels such as telephone, e-mail, fax and even electronic file
submission. They respond quickly to critical incidents and prepare customized plans specifying data collected and formats of reports, detailed recipient notification and other vital details.
- Reporting of the incident:
The company’s specialists are available 24/7, 365 days a year for the first notice of loss to handle worker’s compensation, short-term and long-term disability claims. They develop a step-by-step documentation of all records to provide a complete audit trail for every type
of contract received.
- Converting claim reports into actionable information:
After intake of necessary information, the company helps close claims quickly by providing essential services. Some of these services include triage to ensure escalation of critical situations, performing medical coding, duplicate checking to flag matches, quality assurance reviews, follow-up completion of claims and many more. Claim number assignment is also done to track notices from the company according to your rules.
- Expediting completed reports to key recipients:
The incident reporting process does not end at a claim’s closing, but also includes expedition of completed reports to government agencies in formats like EDI, mail, text message, phone or e-mail. The insurance claim reporting services provider maintains all
current state FROI for worker’s compensation and performs all state filing procedures of FROI and subsequent reports of injury and medical bills.
- Managing risk effectively:
Complete and timely incident reporting results in reduced claims paid out, lower claim handling expenses, and decreased costs. A complete overview of your organization helps to identify and manage risks more effectively.
The Importance and Utility of Outsourcing
If high ASA’s and abandonment rates are a concern, qualified call centers are first line of defense. As with most call centers, there are times when occupancy rates reach 90% – and no one is available to answer the phone.
You could return the call an hour later or the next day, but it may be too late, and they may have already contacted an attorney. This will increase the cost of your claims dramatically and will simultaneously reduce the effectiveness and level of customer service provided by your organization. This is why many of today’s contact centers employ outsourced call centers staffer with claims professionals to improve the customer experience.
By leveraging a contact center for overflow, nights, weekends and holidays, you will improve the efficiency in your organization by as much as 40% while greatly improving your customer experience. All of which impact the bottom line. Today, many high quality call centers outsource FNOL (First Notice of Loss) for overflow and non-peak times.
Insurers with longer than average cycle times of 14.8 days are rated in the bottom 50% in terms of customer satisfaction. – J.D. Power and Associates
At 80%+ call center occupancy your people are busy, turnover increases due to burnout, customer service is poor, and many calls go unanswered. At 50% occupancy your people have some down time, customer service levels are relatively good, and most calls are answered. At 20% occupancy, almost every call is answered, ASA times are short, customer service is superb; however efficiency is low and the cost per claim is astronomical.
Finding the right outsourced call FNOL solution can allow your call center to improve efficiency and reach maximum effectiveness.
Claim Intake and Claims Management Best Practices
Incident reporting must be cost-effective to achieve long-term success in any organization. Cost-effective incident reporting and claims management is dependent upon capturing accurate information in a prompt and well-organized manner. When policyholders report a notice, greeting them professionally is important. Of equal importance, of course, is the professionalism exhibited on the other end of the process – data entry. Trained intake specialists must quickly and accurately ask the right questions and enter the appropriate information into the applicable form using a best practices workflow.
Only through years of first notice of loss (FNOL) experience can claim intake best practices be honed into a streamlined training program. Whether entering notices into a custom application, a standardized application, or your in-house claims management system, capturing the vital details quickly and effectively while maintaining a pleasant demeanor is paramount. Providing medical coding, duplicate checking, quality assurance reviews, and notice completion in addition to streamlined and skilled services keeps costs down and satisfaction up – where they belong.
Popular FNOL and Absence Management Blogs
Here at Actec we’ve been blogging about the importance of FNOL and Absence Management Solutions for several years. Here are a few of our most popular recent blogs:
- Overflow and Call Center Closure Preparedness
- Absence Management and Your Business
- After-Hours Reporting and Claims Management
For more on these and other important topics, return to our blog soon!