Luckily modern RMIS technology exists that can help streamline many of these manual processes  to make an adjuster’s day flow much more smoothly. In a previous posting, we talked about implementing automation and workflow to address this very thing. Setting up business rules to automate routine tasks can have a big impact on productivity.   In fact, we came up with a quick list of 7  that can be easily automated:

1. Create reserves in X amount for any Medical claim that comes in
2. Attach the report of injury or notice of loss to the claim
3. Produce applicable state forms for submission
4. Generate claim acknowledgement letters  
5. Send an email and/or diary to the adjuster, alerting them of new claim activity
6. Set reminders for the adjuster for timely payment review and issuance
7. Alert adjusters when a statute of limitations or other compliance dates are nearing

Automating these time consuming tasks frees up the adjuster to focus on interactions with the employee, employer, providers and other involved parties to provide the best claim outcome.  

While there will never be a technology substitute for experience and knowledge, we can at least help make the day in the life of an adjuster easier by easing their minds of some of the things that they have traditionally had to remember to do!

We recently held a webinar for our clients as a refresher training on processing 1099s using our software solutions.  Since this is most typically a once-a-year kind of thing, it’s easy to forget the steps.  For any DAVID clients who might have missed the webinar, you can contact your Account Manager for access to the recording. 

Here are some helpful tips to keep in mind as you embark upon your annual process:

• There are no changes to the 1099 forms for 2011. What this means is that DAVID clients can use the same program they used last year. In the event an update is mandated by the IRS, we make sure to notify clients several months ahead of time so that they have everything needed before they begin the process.
• It’s never too early to review your vendors! We encourage our clients to start their vendor analysis process before January 1.  Software has many checks and balances to ensure your data is accurate, but let’s face it. It’s still humans that input the data and sometimes a number can get transposed or an address becomes out of date. The vendor analysis process that is part of our 1099 module identifies any data inconsistencies so that users can easily remedy any issues.
• Your claims system is probably just one software package in your organization that tracks 1099 information.  In the event that you need to consolidate your 1099 data, run an export of the data from your system so that you can import it to the software that will be used to generate the printed forms and/or the electronic file.

Happy 1099 Season!

Let’s start with a new policy submission, or a renewal. In both cases, they can be initiated via a Policy Portal by an Agent or a Member. From the very start of the process, the user has options that let them to move forward systematically, step by step, saving their work along the way and allowing them to log off and log on without losing momentum or any data! Once an application or renewal is submitted, workflow is triggered in the back office, where underwriters can accept or reject the submission, ask the agent or member for more information or take the file under review. All with the press of a button.  Back and forth it goes from the submission of a quote to binding and invoicing.

 On the claims side, workflow can prevent critical tasks from falling through the cracks, like reporting to excess carriers, preventing late notice, or notifying reinsurers of potential exposures. In the form of business rules, workflow takes on even greater potential, empowering the end user to create if, then scenarios to generate alerts, diaries, notepads, EDI events or trigger a larger workflow.  Let’s say that you handle a particular line of business in multiple states and each state has different regulations that require you to report in completely different ways on these specific types of claims within a set number of days.  Creating business rules is an easy way to automate the workflow, stay on top of deadlines and remain compliant.

As you can see from these examples, workflow can save you time, money and give you peace of mind. But, don’t just take our word for it, read this Risk & Insurance Insight about how one of our clients reduced their administrative processing time by 50% after implementing NavRisk.  NavRisk automates processes for IPMG

We are glad you asked!  NavRisk 5 is the latest version of our risk management software suite and is the culmination of collaboration with our clients, designed to help them run their operations more efficiently, reduce overall costs and grow their business.  To answer the question, “Who is DAVID?” We are a software company  based in San Francisco that has served the Alternative Risk Market for over 27 years now.  While we are always evolving to stay ahead of industry and technology trends, our philosophy and mission has been consistent – listening to our clients and collaborating with them on products and services that help realize their business objectives.   Our longevity and expertise in the risk management software world may speak for itself, but something that is not as widely known is that most of our clients have worked with us for 10 years or longer, some for over 20 years and much of the DAVID team has been dedicated to our clients for 10 years or longer.  It is this combined strength of our clients and the DAVID team that has created a robust platform meant to serve your needs, from underwriting and policy administration to claims administration and reporting.  

With the introduction of NavRisk 5, the suite provides seamless integration to better manage your exposures.  With our new Policy Portal, your agents and members will be able to easily renew policies, institute interim changes and create endorsements, not to mention the ease with which they will be able to run their own reports.  Your underwriting team will have access to workflow that will speed the process. On the claims side, your adjusters and management alike will delight in the easy to use system. Integrated email, embedded documents in notepads, reserve worksheets and configurable business rules are just a few of the prominent features. And generating reports and analyzing your data has never been easier.

So, if you missed our webinar or the conference this year, no worries! Give us a shout– we would be delighted to arrange a custom-tailored demo just for you and your team.  NavRisk 5 was made for companies just like yours – come and see for yourself!

Packed with many powerful features, NavRisk 5 includes:

• Robust reporting solution leveraging SAP Business Objects platform for powerful business intelligence and analytics
• Improved Claim Intake functionality available on multiple browsers including mobile devices
• Redesigned policy portal providing improved user experience for quoting, renewals and endorsements
• Enhanced configuration options providing clients with the ability to easily modify the application workflow and screens to meet unique business needs
• New reserve worksheet functionality that provides maximum flexibility when performing analysis of reserves before committing them to the claim
• Enhanced email and inbox workflow functionality
• And many more exciting features

A webinar highlighting the new features of NavRisk 5 will be held on Wednesday, November 16^th at 11:00 a.m. Pacific/2:00 p.m. Eastern and is open to DAVID clients and risk management organizations who are interested in learning more about NavRisk 5. For details and to register visit www.davidcorp.com/events. And if you are attending the National Workers’ Comp and Disability Conference in Las Vegas this week, stop by booth #155 to see a live demo of NavRisk 5!

Since our focus is on reducing costs before, during and after a Workers’ Comp claim occurs, we offer many ways of achieving results with NavRisk and in concert with our partners.  From workflow to advanced business analytics, we would love to share all the ways that our products promote cost savings.

Here’s a sneak preview of what some of our Partners will be showcasing:  

Hyland Software is the creator of OnBase, an award-winning ECM platform with over  400 insurance customers. OnBase gives claims teams all the information they need to process claims and handle exceptions fast and according to your business rules. Processing claims faster and more accurately not only means you fight the clock – it means you save money claim after claim.

PreCare is the leading national provider of onsite Injury Prevention, Wellness, Physical Therapy Treatment and Return to Work Job Coaching, and Consulting Services.  PreCare will be sponsoring the debut of the PreVent Award at NWCDC this year honoring organizations that have devoted significant time and resources to develop and implement proactive strategies to prevent workplace injuries. We’d be happy to provide an introduction, or just mosey over to their booth #547 to learn more about this industry benchmark and their innovative service deliverables to significantly reduce employer claim costs!

Effective Health has a great new product offering that integrates the latest medical based evidence guidelines into their Utilization Review Preauthorization software. We’ve arranged for them to stop by the booth during the show and if you miss them, you’ll still be able to see how we integrate their preauthorization software  with NavRisk Claims.

As you can see, there is so much to talk about and we encourage you to stop by and have a chat. As you know, we grow and build our products with the direct help of our clients, and we welcome all ideas for consideration!

If you are attending, make sure to stop by booth #155 to see us, along with some of our partners, and get a demo of our NavRisk^® Suite, a full service risk management solution currently in production with various Insured Organizations, TPAs, and Risk Pools.  We are pleased to report that NavRisk has helped clients dramatically reduce their cost per claim, cut administrative costs in half and recognize six-figure operational savings. 

If you’d like to arrange a meeting ahead of time, contact Mary-Margaret Dale at mdale@davidcorp.com. Or you may request a meeting through the handy conference portal MyNWCDC.   We look forward to seeing you!

For TPAs, it’s a question of managing profit margins, while providing all of these value-added services, remaining flexible and offering sterling customer service to stay afloat.

So if you’re a TPA, how do you stay on top of everything? How can you report to CMS with minimal effort? Provide your clients with on-demand reporting?  Update your reports and dashboards and offer it on mobile devices?  Offer customer service that outshines the competition?  And, make a profit?

Obviously, a system to support you is the first step. Without a reliable platform, you can’t get to the next step or the one after that. A solid comprehensive platform is an essential foundation for creating workflow that is flexible enough to grow with your ever changing business needs. Automate your reporting. Provide your clients with a reporting portal that allows for self-service. Take manual processes that require human intervention and find a business rule or an automated workflow that speeds the work. Use predictive modeling to triage your claims and identify trends. Not only will you channel work to the right person at the right time, but you will educate your less experienced personnel through the inclusion of business rules that will guide them through the life cycle of a claim, teaching them as they go, from first report of injury to final adjudication.

Of course, one size doesn’t fit all. We know that. A smaller TPA may be looking for something a little different than a larger TPA.  Each of your clients may be more or less demanding, with an entirely different level of complexity involved. That is the beauty of automation and business rules. Maybe all you need to do is schedule and email reports on a monthly, quarterly or annual basis. Or, maybe you have to create a client portal and allow your clients access to run their own reports whenever they want.  Minimal output or maximum output can be achieved easily with the right tools, flexible enough for you to configure yourself.  

With the ever changing nature of risk, how can your systems remain the same? With the constant demand for more meaningful data and insight into your operations, how can you rely on manual processes? With an aging adjuster population, you need tools to educate, business rules to validate and workflow to maintain strict control. Keeping your costs in check requires tools that are looking out for your bottom line.  Tools like advanced reporting and analytics. Document management. Business Process Management.  You may be under pressure, but you are not alone.

Having an integrated pathway leads to business insights. It can take a formerly detached set of business units and unite them through a common platform and a common set of data.

 Remember all of those spreadsheets?  It’s time to throw them out and rethink how you can:

• Automate  manual processes- there is no need for keeping a series of ever-growing spreadsheets where formulas can break and spread misinformation.

Worried about critical milestones being missed in the process? Why not change your workflow?

• Increase your productivity and empower your users through business process management- workflow that goes beyond your current needs and takes you to greater heights allowing for big picture thinking and preventing important tasks from slipping through the cracks

Claims not getting to the right person at the right time?

• Find efficiencies where you formerly found bottlenecks- see just where the process is being bogged down and find practical ways of directing and triaging claims.

Underwriting saying one thing and Claims another?

• Connect your systems so that one hand knows what the other is up to.

Overwhelmed by the quantity of mail, faxes and files you need to store and save?

• Go paperless- why search for that file or go to the archive when you can click a button and find it attached to the respective  policy or claim?

Want access to your data whenever you want it?

• Use mobility to be present when it is most important- having that data available on an iPad or a smartphone  enables a significant delivery mechanism for informed decisions.

In the end, whether you are a Risk Pool, a Self-Insured entity, a TPA or a Captive- it all boils down to knowing what the data is telling you about your exposures. You need to know that you have proper integration of your core systems and the best reporting possible to address what currently requires attention. It changes every day and you need to know that you’ll be able to respond with the degree of complexity and flexibility required.

These results are not surprising. Exercise is energizing and motivating and for the most part, helps people focus on accomplishing the task at hand. Offering time during the workday to exercise could be an important tactic in a company’s overall risk management strategy. Think about it. Exercise time often competes with family time, house hold chores and other obligations that occupy our precious outside of work time. And for most people, having to choose between helping a child with homework or going to the gym, is a no-brainer. Offering exercise time during work hours shows employees that the company cares about their health and well-being. The feel good benefits of exercise experienced by the employee can in turn be put back into producing good results for the company. Taking this one step further, a healthy employee is more likely to recover from illness and injury more quickly, and in the world of workers’ comp, this often means less loss time which translates into lower costs.

With the continued focus on wellness in the workplace, we can anticipate more and more employer sponsored programs that emphasize a healthy work environment. And doesn’t it appear to be a win-win for all? The employee is given the opportunity to maintain a healthy lifestyle, the employer gets a happier and more productive employee which may even lead to a decline in workers’ comp claim frequency. That may sound like a perfect world, but with a little out of the box thinking, as exhibited by the Swedish company in the OH&S story, it may just be achievable!

Occupational Health & Safety. 2011. “Time Off for Work Exercise Linked to Increased Productivity.” Accessed August 17, 2011. http://ohsonline.com/articles/2011/08/17/time-off-for-work-exercise-linked-to-increased-productivity-study.aspx