How to Identify Claims High-Risk Insurance Claims Faster and More Accurately

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High-risk insurance claims can wreak havoc if not detected quickly. View this presentation to see how Trillium Software will pinpoint them for you…faster and more accurately.

Technology Economy & Finance Business

How to Identify
High-Risk
Insurance Claims
Faster and
More Accurately

2
High-risk insurance
claims will wreak havoc if
not detected quickly

3
Early warning indicators
are hidden in your
insurance claims files

4
Trillium will pinpoint them for
you…faster and more
accurately

5
We automate the continual
analysis of free form text and
scanned documents across
thousands of claims files –
the 50% of information you
cannot reach today.

6
Insurance Claims Adjuster Note
Claimant complains of chron headaches,
nausa and is having problems
remembering things. Claimant has been
prescribed morphine tabs and remains OOW.
Step #1 – Access Your Free Form Text

7
Insurance Claims Adjuster Note
Claimant complains of chron headaches,
nausa and is having problems
remembering things. Claimant has been
prescribed morphine tabs and remains OOW.
Step #2 – Flag Potential Risk Indicators

8
Insurance Claims Adjuster Note
Claimant complains of chron headaches,
nausa and is having problems
remembering things. Claimant has been
prescribed morphine tabs and remains OOW.
We even pinpoint misspellings, abbreviations and vernacular
Step #2 – Flag Potential Risk Indicators

9
Trillium combines
data from
multiple sources
to analyze and
generate results
Medication
Step #3 – Correlate with scanned documents

10
Minimize risk
Step #4 – Alert Right Adjuster at Right Time

11
Minimize risk
Reduce costs
Step #4 – Alert Right Adjuster at Right Time

12
Minimize risk
Reduce costs
Decrease cycle time
Step #4 – Alert Right Adjuster at Right Time

13
Minimize risk
Reduce costs
Decrease cycle time
Maximize resource allocation
Step #4 – Alert Right Adjuster at Right Time

14
Minimize risk
Reduce costs
Decrease cycle time
Maximize resource allocation
Develop timely action plans
Step #4 – Alert Right Adjuster at Right Time

15
Look beneath the surface.
Uncover hidden risks in your
claims files before they wreak
havoc…

For More Information
daniel_gilligan@trilliumsoftware.com
860-930-3179
www.claimsdataquality.com

Claims-Made Policies May Cover Claims Submitted Outside the Reporting Period. As a rule, liability insurance policies contain a condition requiring timely notice of a claim against the insured, so that the insurer has an opportunity to adequately investigate and defend the claim. A recurring issue is what happens when notice is not timely. Does the insured lose coverage, automatically, or only when the insurer is prejudiced by the late notice? The answer can vary depending on what state’s law applies – in Wisconsin, this issue is seemingly answered not as much by policy language or case law but by two different statutes, Wis. Stat. §§ 631.81 and 632.26, each of which expressly states than an insured loses coverage only where the insurer is “prejudiced” by late notice.

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How to Identify Claims High-Risk Insurance Claims Faster and More Accurately

1. How to Identify High-Risk Insurance Claims Faster and More Accurately

2. 2 High-risk insurance claims will wreak havoc if not detected quickly

3. 3 Early warning indicators are hidden in your insurance claims files

4. 4 Trillium will pinpoint them for you…faster and more accurately

5. 5 We automate the continual analysis of free form text and scanned documents across thousands of claims files – the 50% of information you cannot reach today.

6. 6 Insurance Claims Adjuster Note Claimant complains of chron headaches, nausa and is having problems remembering things. Claimant has been prescribed morphine tabs and remains OOW. Step #1 – Access Your Free Form Text

7. 7 Insurance Claims Adjuster Note Claimant complains of chron headaches, nausa and is having problems remembering things. Claimant has been prescribed morphine tabs and remains OOW. Step #2 – Flag Potential Risk Indicators

8. 8 Insurance Claims Adjuster Note Claimant complains of chron headaches, nausa and is having problems remembering things. Claimant has been prescribed morphine tabs and remains OOW. We even pinpoint misspellings, abbreviations and vernacular Step #2 – Flag Potential Risk Indicators

9. 9 Trillium combines data from multiple sources to analyze and generate results Medication Step #3 – Correlate with scanned documents

10. 10 Minimize risk Step #4 – Alert Right Adjuster at Right Time

11. 11 Minimize risk Reduce costs Step #4 – Alert Right Adjuster at Right Time

12. 12 Minimize risk Reduce costs Decrease cycle time Step #4 – Alert Right Adjuster at Right Time

13. 13 Minimize risk Reduce costs Decrease cycle time Maximize resource allocation Step #4 – Alert Right Adjuster at Right Time

14. 14 Minimize risk Reduce costs Decrease cycle time Maximize resource allocation Develop timely action plans Step #4 – Alert Right Adjuster at Right Time

15. 15 Look beneath the surface. Uncover hidden risks in your claims files before they wreak havoc…

16. For More Information daniel_gilligan@trilliumsoftware.com 860-930-3179 www.claimsdataquality.com

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