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Claim Management
Processing Services
A good claims’ experience is a prominent key to improve
customer retention and safeguard a company’s brand
proposition!
HVANTAGE TECHNOLOGIES INC.
23463 Haynes St. West Hills Los Angeles California 91307
Table of Contents
1. Introduction
2. Why outsource Claim
Management Process?
3. Benefits
4. Our Claim Management
Services
5. The Hvantage
Technologies Advantage
6. About Hvantage
Technologies
7. Our Other Capabilities
Introduction
● The insurance industry is undergoing a major transformation
partly due to disruptions brought in by new technology,
changing customer behavior and demographics, and new
distribution models.
● In addition, insurers are grappling with economic
uncertainty, low interest rates, global climate
catastrophes and rigid local and global regulations.
● Insurance companies eventually have to focus on reducing cost
structures, embedding big data analytics and technology for
better customer insights and improved business outcomes.
● Hence, effective claims handling becomes imperative to
maintain healthy operating and loss ratios.
Best Solution is to
Outsource!
● With market deregulation and
escalation in risk as a result of
natural disaster and terrorism
looming large, the insurance
industry is facing a lot of cost
pressure.
● Any industry with an immediate
need for cost cutting is an ideal
contender for offshoring.
● If your organization has to manage
large volumes of insurance claims
administration, outsourcing this
task will be cost-efficient.
But, Why
Outsource Claim
Management
Processing?
Benefits
Greater
customer
satisfaction
Customer
service of a
high quality
in spite of
business
volume
fluctuation
Reduction in
operations
cost
Greater
accuracy in
settlement of
claims
Fraudulent
claims
management
To improve the efficiencies of their processes for
administration of claims, more and more of leaders
in the insurance industry are turning towards
outsourcing. The benefits that can avail through
outsourcing of insurance claims processing include
the following:
Our Claim
Management
Services
● Insurance Claim Setup
● Insurance Claim Eligibility and Estimation
● Claim Document Imaging
● Adjudication on a fast track
● Adjudication of full claims
● Subrogation
● Claim Support and Auditing
● Settlement of documents and Accounts
● Legacy Application Modernization
● Disbursement
Our General Process!
1.
Enter Assignment into
Xactware:
● Property Owner /
Risk Information
● Claim Information
● Client Group
● Policy Information
● Coverage Details
● Add Mortage
Holder
2.
Loss Notice / Personal
Rule-
Once we enter
assignment,each client has
Adjusters as per the loss city
and send notify about adjuster
information to us. We check
this and send adjuster details
to Desk Adjuster by using
standard format through Xact.
3.
Adjuster Document
Management-
We upload document of
adjuster received on
email to Zoho crm.
4.
ISO Entry of Proctor
Assignments
We run daily report and
generating ISO results
from regular process.
Once we get ISO results
we need to upload
document in respective
assignments.
5.
Service Center Map:
We run daily report and
generating Service Center
Map given Link. Once we
get service center map
we need to upload
document in respective
assignments.
6.
Rechecking of
assignments and Cat
Code:
We run daily report and
match with Cat Report. If
there is any discrepancy we
need to update Cat code in
respective assignments.
7.
Creation of $0
Invoices:
Once new assignment is
entered in Xact, We
create invoice again new
assignment in QB with
“Zero” amount.
8.
Creation of Main Invoices-
Once Claim gets closed we
receive email from reviewer to
create invoice. We check that
assignment and create invoice
in QB as per applicable billing
schedule. Also send invoice to
Desk adjuster or assigned email
id where needed.
11.
Receive Payment-
We make all invoices paid
in QB against which we
received payment.
12.
Creating Pay Roll-
We make Pay Roll on fort
nightly basis and send to
all adjusters via email so
that adjuster can come to
know about payment
with all details.
13.
Paid Marking-
After making pay roll we
mark all these
assignment as paid in
QB, so that there will be
no outstanding show in
QB.
15.
Reconciliation of Monthly
Payment v/s Invoice –
We reconcile all the payment
received against invoices we made.
If we found any discrepancy we
mention in our notes and send back
to respective person.
14.
Replies of Emails and
Queries-
In addition with all above
we monitor email
account and reply to all
emails where needed.
9.
SIMS Payment
Entry –
After creating
invoices we enter
same amount in SIMS
so that client can pay
the amount.
10.
Transfer Request –
After creating invoices
we enter same amount in
SIMS so that client can
pay the amount.
Apart from all these process we complete all other
task which we received from Client.
The
Hvantage
Technologies
Advantage
Our team at Hvantage Technologies is dedicated to adding
value by generating savings, improving and increasing your
core process capabilities by speedily and seamlessly
migrating your processes:
● We provide end-to-end services across the claims value
chain for personal and commercial lines of businesses
including specialty lines.
● From First Notification of Loss (FNOL) to assessment,
claims adjudication, subrogation, reserve management
and payments.
● We reduce transaction processing time without
compromising on quality and accuracy of transactions
● We provide compliance with state, federal and industry
regulated guidelines.
● We offer customized platforms, processes and resources
specially designed for your business requirements.
About Hvantage
Technologies
● Founders: Founded in 2011 by Neelesh Jain - serial entrepreneur in telecom &
real estate
● Locations: 2 offices in Indore, India with 150 technology and operations team
● Expertise: Development Support, Back Office Support, Customer Support,
E-Commerce Management Support, Offshore & Outsourcing Support Services
● Domain Expertise: Healthcare, Banking, Finance, IT & Technology, Internet,
Shared Economy, and e-Commerce
● Lean Operating Model: Sales and support in US & operations in India
-
-
Our Clients
Our Other Capabilities….
User Experience
(Web, Mobile, Desktop & Internet of
Things)
Business
Process
(Rules, Workflow &
Transactions)
Data Store
(Real-time & High
Performance)
Business
Intelligence &
Analytics
(Insights & Trends)
Big Data
(Preparation &
Processing)
Product development and management
Mobile, Web, Desktop Application Design and Development
Technology Services
Desktop and Infrastructure Support
Technology Capabilities
Analysis, Development
& Quality delivered
using Agile Process.
Build
Product management,
strategic alignment &
architecture
assessment.
Manage
Continuous
improvement, product
support & training.
Support
Onsite creative team
to design
multi-platform
dynamic effective user
interfaces.
Design
24/7 operations support across three countries USA (Onsite), Brazil(Near Shore) and India (Offshore)
High tech operations office in India
Expertise in ECommerce, Logistics, General Administration,
Accounting
Desktop and Infrastructure Support
Operations Capabilities
We have carefully
built a culture
where customer
is our first
priority.
Care
We practice industry
standard technology
& processes to secure
your information.
Security
We provide
competitive
advantage to our
customers with
operational innovation
and efficiency.
Efficiency
Our talented
operations team is
fluent in English,
trustworthy &
experienced in
operational
Talent
Native mobile applications (iOS, Android & Windows)
Dedicated onsite designers and developers.
Faster time of market with existing tested mobile components to plug in.
End to end development including deployment to app store.
Mobile Capabilities
Hvantage creates
designs that
reflect client’s
outlook
Design
Using innovative
ideas &
result-oriented
implementations
to develop
successful digital
strategy for your
business
Idea Meticulously
thought out
design &
development,
SEO ,
E-Commerce and
Back Office
support services
Plan
Generate relevant
traffic to your
website from
various search
engines
SEO
Our
Offices
Office No. 1
18
Office No.2
Hvantage – India Location – Indore City
Indore is an inviting opportunity with
quality infrastructure at low cost.
- Talent/Opportunities: Only city in India
with the presence of most reputed
international colleges Indian Institute of
Management (IIM) and Indian Institute
of Technology (IIT). There are over 50
colleges and educational academies in
Indore feeding the talent to domestic &
international businesses.
- Cost: A Tier 2 city, keeps the TCO
almost half of the big 5s.
• Comparing to Los Angeles its half in area and population
(562 sq/km for 2.1 Million).
• Indore has 2 operational and 1 proposed IT park, with
presence of InfoSys, TCS & Collabera.
• Indore is connected with an International Airport &
Rail/Road.
• Bus Rapid Transit system keeps traffic in control.
• Indore provide the key ingredients of life including great
weather, food variety, entertainment parks, sight seeing,
malls, hospitals, sports institute, education and a family
friendly place to retain the talent.
• Resources: Wikipedia, IIM Indore, IIT Indore
20
State of art facility center in Indore, India
Hvantage’s India office is a state of the art facility
designed around maximum productive software
development environment. The open floor design
encourages communication and collaboration, both
between techies and with our clients.
• 8000 sq. feet professionally arranged space (2 offices)
• Seating capacity 150 associates
• 6 manager’s cabins
• 24 hours power backup
• Large conference rooms
• Internet connection up to 100 mbps, multiple leased lines for
client requirements
• Ample parking space
• 24 hours security guard
• Server room with restricted access
Hvantage India Offices
CONTACT
HVANTAGE TECHNOLOGIES INC
info@hvantagetechnologies.com
www.hvantagetechnologies.com
Address:
23463 Haynes st
West hills Los Angeles
California 91307
Phone:+1-323-250-0588 ,
+1-347-918-3427
THANK YOU!

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Claim Management Processing Services

  • 1. Claim Management Processing Services A good claims’ experience is a prominent key to improve customer retention and safeguard a company’s brand proposition! HVANTAGE TECHNOLOGIES INC. 23463 Haynes St. West Hills Los Angeles California 91307
  • 2. Table of Contents 1. Introduction 2. Why outsource Claim Management Process? 3. Benefits 4. Our Claim Management Services 5. The Hvantage Technologies Advantage 6. About Hvantage Technologies 7. Our Other Capabilities
  • 3. Introduction ● The insurance industry is undergoing a major transformation partly due to disruptions brought in by new technology, changing customer behavior and demographics, and new distribution models. ● In addition, insurers are grappling with economic uncertainty, low interest rates, global climate catastrophes and rigid local and global regulations. ● Insurance companies eventually have to focus on reducing cost structures, embedding big data analytics and technology for better customer insights and improved business outcomes. ● Hence, effective claims handling becomes imperative to maintain healthy operating and loss ratios.
  • 4. Best Solution is to Outsource!
  • 5. ● With market deregulation and escalation in risk as a result of natural disaster and terrorism looming large, the insurance industry is facing a lot of cost pressure. ● Any industry with an immediate need for cost cutting is an ideal contender for offshoring. ● If your organization has to manage large volumes of insurance claims administration, outsourcing this task will be cost-efficient. But, Why Outsource Claim Management Processing?
  • 6. Benefits Greater customer satisfaction Customer service of a high quality in spite of business volume fluctuation Reduction in operations cost Greater accuracy in settlement of claims Fraudulent claims management To improve the efficiencies of their processes for administration of claims, more and more of leaders in the insurance industry are turning towards outsourcing. The benefits that can avail through outsourcing of insurance claims processing include the following:
  • 7. Our Claim Management Services ● Insurance Claim Setup ● Insurance Claim Eligibility and Estimation ● Claim Document Imaging ● Adjudication on a fast track ● Adjudication of full claims ● Subrogation ● Claim Support and Auditing ● Settlement of documents and Accounts ● Legacy Application Modernization ● Disbursement
  • 9. 1. Enter Assignment into Xactware: ● Property Owner / Risk Information ● Claim Information ● Client Group ● Policy Information ● Coverage Details ● Add Mortage Holder 2. Loss Notice / Personal Rule- Once we enter assignment,each client has Adjusters as per the loss city and send notify about adjuster information to us. We check this and send adjuster details to Desk Adjuster by using standard format through Xact. 3. Adjuster Document Management- We upload document of adjuster received on email to Zoho crm. 4. ISO Entry of Proctor Assignments We run daily report and generating ISO results from regular process. Once we get ISO results we need to upload document in respective assignments. 5. Service Center Map: We run daily report and generating Service Center Map given Link. Once we get service center map we need to upload document in respective assignments. 6. Rechecking of assignments and Cat Code: We run daily report and match with Cat Report. If there is any discrepancy we need to update Cat code in respective assignments. 7. Creation of $0 Invoices: Once new assignment is entered in Xact, We create invoice again new assignment in QB with “Zero” amount. 8. Creation of Main Invoices- Once Claim gets closed we receive email from reviewer to create invoice. We check that assignment and create invoice in QB as per applicable billing schedule. Also send invoice to Desk adjuster or assigned email id where needed.
  • 10. 11. Receive Payment- We make all invoices paid in QB against which we received payment. 12. Creating Pay Roll- We make Pay Roll on fort nightly basis and send to all adjusters via email so that adjuster can come to know about payment with all details. 13. Paid Marking- After making pay roll we mark all these assignment as paid in QB, so that there will be no outstanding show in QB. 15. Reconciliation of Monthly Payment v/s Invoice – We reconcile all the payment received against invoices we made. If we found any discrepancy we mention in our notes and send back to respective person. 14. Replies of Emails and Queries- In addition with all above we monitor email account and reply to all emails where needed. 9. SIMS Payment Entry – After creating invoices we enter same amount in SIMS so that client can pay the amount. 10. Transfer Request – After creating invoices we enter same amount in SIMS so that client can pay the amount. Apart from all these process we complete all other task which we received from Client.
  • 11. The Hvantage Technologies Advantage Our team at Hvantage Technologies is dedicated to adding value by generating savings, improving and increasing your core process capabilities by speedily and seamlessly migrating your processes: ● We provide end-to-end services across the claims value chain for personal and commercial lines of businesses including specialty lines. ● From First Notification of Loss (FNOL) to assessment, claims adjudication, subrogation, reserve management and payments. ● We reduce transaction processing time without compromising on quality and accuracy of transactions ● We provide compliance with state, federal and industry regulated guidelines. ● We offer customized platforms, processes and resources specially designed for your business requirements.
  • 13. ● Founders: Founded in 2011 by Neelesh Jain - serial entrepreneur in telecom & real estate ● Locations: 2 offices in Indore, India with 150 technology and operations team ● Expertise: Development Support, Back Office Support, Customer Support, E-Commerce Management Support, Offshore & Outsourcing Support Services ● Domain Expertise: Healthcare, Banking, Finance, IT & Technology, Internet, Shared Economy, and e-Commerce ● Lean Operating Model: Sales and support in US & operations in India - - Our Clients
  • 15. User Experience (Web, Mobile, Desktop & Internet of Things) Business Process (Rules, Workflow & Transactions) Data Store (Real-time & High Performance) Business Intelligence & Analytics (Insights & Trends) Big Data (Preparation & Processing) Product development and management Mobile, Web, Desktop Application Design and Development Technology Services Desktop and Infrastructure Support Technology Capabilities Analysis, Development & Quality delivered using Agile Process. Build Product management, strategic alignment & architecture assessment. Manage Continuous improvement, product support & training. Support Onsite creative team to design multi-platform dynamic effective user interfaces. Design
  • 16. 24/7 operations support across three countries USA (Onsite), Brazil(Near Shore) and India (Offshore) High tech operations office in India Expertise in ECommerce, Logistics, General Administration, Accounting Desktop and Infrastructure Support Operations Capabilities We have carefully built a culture where customer is our first priority. Care We practice industry standard technology & processes to secure your information. Security We provide competitive advantage to our customers with operational innovation and efficiency. Efficiency Our talented operations team is fluent in English, trustworthy & experienced in operational Talent
  • 17. Native mobile applications (iOS, Android & Windows) Dedicated onsite designers and developers. Faster time of market with existing tested mobile components to plug in. End to end development including deployment to app store. Mobile Capabilities Hvantage creates designs that reflect client’s outlook Design Using innovative ideas & result-oriented implementations to develop successful digital strategy for your business Idea Meticulously thought out design & development, SEO , E-Commerce and Back Office support services Plan Generate relevant traffic to your website from various search engines SEO
  • 19. Hvantage – India Location – Indore City Indore is an inviting opportunity with quality infrastructure at low cost. - Talent/Opportunities: Only city in India with the presence of most reputed international colleges Indian Institute of Management (IIM) and Indian Institute of Technology (IIT). There are over 50 colleges and educational academies in Indore feeding the talent to domestic & international businesses. - Cost: A Tier 2 city, keeps the TCO almost half of the big 5s. • Comparing to Los Angeles its half in area and population (562 sq/km for 2.1 Million). • Indore has 2 operational and 1 proposed IT park, with presence of InfoSys, TCS & Collabera. • Indore is connected with an International Airport & Rail/Road. • Bus Rapid Transit system keeps traffic in control. • Indore provide the key ingredients of life including great weather, food variety, entertainment parks, sight seeing, malls, hospitals, sports institute, education and a family friendly place to retain the talent. • Resources: Wikipedia, IIM Indore, IIT Indore
  • 20. 20 State of art facility center in Indore, India Hvantage’s India office is a state of the art facility designed around maximum productive software development environment. The open floor design encourages communication and collaboration, both between techies and with our clients. • 8000 sq. feet professionally arranged space (2 offices) • Seating capacity 150 associates • 6 manager’s cabins • 24 hours power backup • Large conference rooms • Internet connection up to 100 mbps, multiple leased lines for client requirements • Ample parking space • 24 hours security guard • Server room with restricted access Hvantage India Offices
  • 21. CONTACT HVANTAGE TECHNOLOGIES INC info@hvantagetechnologies.com www.hvantagetechnologies.com Address: 23463 Haynes st West hills Los Angeles California 91307 Phone:+1-323-250-0588 , +1-347-918-3427