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1 30   csc 1 30 csc Presentation Transcript

  • Integrated Claims SolutionsChris CharltonJeff Ninowski
  • The Current State of Claims• Solvency II, Dodd‐Frank, unclaimed life benefits, etc. are changing how carriers structure, price, sell and service their productsWorst economic environment since the Great Depression causing• High costs, high unemployment, high premiums• 70% of an organization’s cost –20% managing the claimLegacy systems are old and difficult to maintain• No one system for core claims processing• Systems are rich with data that is both untapped and underutilized REGULATIONREGULATIONECONOMYECONOMYSYSTEMSSYSTEMSDEMOGRAPHICSDEMOGRAPHICSMaintaining expertise while attracting new claim industry recruits has become a major issue• Thousands of industry professionals leaving as Boomers retire
  • Reduce leakage and claims costsPrioritize, route and track activities with robust workflow or business process management applicationsEnd to End integrated analytics for easy reportingIntegration of both core and non‐core functionality• Asbestosis claims • Disability managementEstablish role based user interfaces with wizards and scripting to reduce errors and on‐going training costsIncrease staff productivity with better task management, automation and consistencyBenefits of the Modern Claim System
  • CSC is ClaimsRISKMASTER AcceleratorVendor Solutions Suite
  • Incident ReportingIncident ReportingClaimsClaimsData InterfacesData InterfacesIntegrated Disability ManagementIntegrated Disability ManagementMedical Bill ReviewMedical Bill ReviewWebFormsWebFormsDataToolsDataToolsMedia Content ManagementMedia Content ManagementMedical CaseManagementMedical CaseManagementServicesServicesRISKMASTERBusiness AnalyticsRISKMASTERBusiness AnalyticsLegalLegalEDIEDIWeb‐based software used for all your Claims Administration, Risk Management  and Incident Reporting NeedsWeb‐based software used for all your Claims Administration, Risk Management  and Incident Reporting NeedsMobilityMobility MMSEAMMSEA
  • We Focus on Your Industry Drivers and GoalsOur ValueYour Drivers• Web forms• Trending and analysis• MMSEA, HIPAA, SOX, and OSHA compliance• Data security• No reliance on vendor schedules• Data Analytics• Business Analytics• System flexibility• 3rd party system integration• Straightforward data analysis • Easily configurableTPA, Pools and Insurance• Automated reporting• Data Conversion/Tools• Easy personalizationTPA, Pools and Insurance• Automated reporting• Data Conversion/Tools• Easy personalizationHealthcare• Timely incident reporting• Data security and reporting• Regulatory complianceHealthcare• Timely incident reporting• Data security and reporting• Regulatory complianceCorporate Claims• Single source of data• Self‐sufficient data analysis• System flexibilityCorporate Claims• Single source of data• Self‐sufficient data analysis• System flexibilityService OptimizationBottom Line ImpactProcess Stability
  • Application OutsourcingData ExchangeBusiness AnalyticsMedical Bill ReviewLegal Services SuiteRisk Management Information ServicesPolicy TrackingClaims Management Incident ReportingMedia Management ServicesRisk Analysis  Self Insured/Self AdministeredTPAs, Pools and InsuranceHealthcareManufacturing/TransportationRetail, Grocery,  & Service IndustryChemical,Energy &NaturalResourcesPublic Sector 
  • LEGAL SOLUTIONS SUITEMatter ManagementWeb‐based software that simplifies the billing process, tracks counsel performance, and promotes best practices in managing legal matters.
  • What is Legal Solutions Suite?Legal E BillProvides legal firms a method to submit invoices electronicallyLegal Bill Analyzer Legal Matter ManagementProvides companies a way to automate their billing guidelines.  As firms submit bills, LBA automatically checks the invoices against the guidelines and flags non‐compliant submissionsProvides companies a means for on‐line collaborative budgeting, staffing and case planning with it’s legal firms
  • Provides quick and robust reporting on legal expenses by firm, matter and line of businessReduces the adjuster’s workflow by automating the bill review timeControls legal expensesAssist in managing your  legal expensesLegal Solutions SuiteMeasure firms’ performance against best practicesAutomates and streamlines collaboration with outside counsel      
  • Improve vendor management by allowing the claimsprofessional to make assignments, review work product,process invoices, and rate vendors from one systemVENDOR SOLUTIONS SUITE
  • Vendor Solutions Suite• Vendor‐initiated registration• Electronic vendor assignment• Expansion of LSS platform to multiple vendor types• Vendor ratings• Total cost of claim reporting through Business ObjectsVendor Solutions Suite
  • Guideline ComplianceWhy VSS?Speed and QualityEffective Vendor ControlGuideline ComplianceDecrease in processing timesEfficient automated process
  • FRAUD ANALYTICS SUITEAll fraud conditions, always checked, ALL the time, EVERY time
  • Why It WorksFraud Analytics Suite
  • Fraud Analytics Suite ComponentsBusiness RulesPredictive Analytics• Customer Rules• Scoring & ReferralIdentity SearchNCIBCommercialMailboxSanctionedDoctorsPeople/Vehicle Watch ListOrganization Watch ListCustomer Fraudulent Claims
  • The industry’s leading general damages assessment to assist adjusters in the evaluation of bodily injury claimsCOLOSSUS
  • Thorough Evaluations Discipline ApproachObjective and In‐depthEffective Negotiations Increased ConfidenceFair and Consistent Settlements Promotes ConsistencyTraining Tool Methodology for Best PracticesBusiness Value of ColossusUsing objective facts to determine recommended settlement offers for similar claim’s
  • 2Work™ for Adjuster•Consolidated devices and streamlined workflow offer more efficient operations•Increased usability and ease of use increase adjuster satisfaction•Field adjusters need fewer devices –and have choices (iPad, Android, Playbook)•Application offers rich data capture (pictures, video, location, etc.)•Light, agile, instant on devices with long lasting batteries• Deploy on‐premise or  in cloud (hosted)Claims
  • Operational Day to Day Analytics Strategic AnalyticsExplorerInternet‐style search capabilityDashboardsgraphs, dials, traffic light statusDashboardsgraphs, dials, traffic light statusReport Enginecreation, distribution and analysis
  • CLAIMS APPLICATIONSWHY CSC’S6 to 8% savings with LSS30% increase in SIU referrals with Fraud Analytics Suite40% reduction in manual processes 700 plus Claims Customers with over 500 on the RISKMASTER platformHistorical Matching Component in Colossus45 day implementation times for tools
  • “With VSS, I can keep vendor profiles within the system including insurance,W‐9 and credential certificates” Rick Hayne, President Nexxus Solutions Group“Fraud Analytics Suite increased my SIU referrals by 25% in the first 6 months of use”  John Sargent, Director MetLife Auto and Home“With RISKMASTER Accelerator, we lowered our workers comp costs by 3M dollars”   Ginger Huskey, Risk Coordinator, City of Knoxville”“Legal Solutions Suite saved us 15% in one year alone”  Stuart Bailey, VP of Claims Kemper Insurance
  • QUESTIONS???