ClaimAble Blog

Claims leakage represents the difference between the amount actually paid out on claims, and what should have been paid out. It refers to the money lost during the claim settlement process from preventable causes; such as inefficient processing, human error, outdated operational procedures and fraud.

Claims software, like ClaimAble, can actually help reduce claims leakage. It all comes down to making informed business decisions and dedicated applications are making this easier and simpler. Identifying claims leakage is a difficult problem. However, equally as difficult, if not more challenging is the task of reducing it! There are certain things that software is inherently good at, such as data analysis, that can result in a dramatic reduction in preventable losses.

As the creators of ClaimAble, we’ve compiled a list of the key features of our claims software that can provide you with the information required to cut down on claims leakage.

1. Speed and efficiency.

By reducing overall claim processing time, you decrease the chances of paying out more than necessary. If the claim is resolved as quickly as possibly, additional costs – such as those incurred by lawyers, contractors and other third parties – are significantly reduced. Claims software facilitates the prompt resolving of claims by helping to establish a common workflow and by providing time saving tools.

2. Trend analysis.

When the number of claims stored becomes sufficiently large, trends can be identified for different types of claims, with consideration of common criteria. This can be a powerful fraud prevention tool and by highlighting claims that fall outside the most common patterns, this potentially reveals erroneous or fraudulent claims. Staff can then make informed decisions on whether to investigate further from a list of statistically unusual claims. The software alerts the user to any activity that deviates from the standard trends and sheds light on potential sources of claims leakage.

3. Data mining and crowd sourcing.

A significant source of claims leakage is the problem of overpaying for labour, contractors, agents and other suppliers. This part of the claims process often involves outsourcing or appointing external individuals or companies. Claims management software can analyse trends over time, finding the average costs paid and display alerts where appropriate if a discrepancy is found as well as making price suggestions based on the market.

4. Increased data integrity.

Sometimes costs can be inflated from erroneous data or missing records. ClaimAble is an example of an application that focuses on increasing data integrity by cutting out sources of inaccuracy such as human error. User interface validation and pre-save checks can go along way to ensuring data stays meaningful and correct throughout the claim life cycle. This ultimately helps reduce unnecessary leakage that might otherwise be incurred by having to retrospectively correct mistakes.

5. Establish business rules.

Part of an efficient claims workflow is being able to handle a wide variety of cases. Flexible claims software can help establish business rules that cater to the majority of eventualities, so staff know how to proceed when a claim deviates from the common path. This reduces the amount of time and resources required to resolve the claim, cutting down on a source of claims leakage.

6. Exception handling.

There are always exceptions to the normal, and being able to handle these edge cases is an effective way to reduce claims leakage. Over paying for a claim can occur as a result of the increased resources that would otherwise be required to manage a claim that requires special attention. Claims software can be sensitive to the nature of such claims, accommodating the additional requirements and alerting users when certain events occur.

There are many other factors that influence claims leakage, but we believe the above list covers some of the significant improvements delivered by effective use of claims software, such as ClaimAble. In providing the tools and information to make informed decisions, claims software can deliver huge reduction in losses by truly leveraging your claims data effectively.

This article aims to dispel any uncertainly about the difference between cloud computing and SaaS, and explain how these exciting technologies translate to the business user.

Businesses have a lot to gain from exploiting the next generation of internet services – especially law firms. We are not talking web-enabled legacy applications or simple web based services, but full-blown web based enterprise class applications. Concerns left over from the days of the early internet about security and lack of control ensure that dated, legacy systems are firmly engrained into the psyche of IT departments as their only viable option. Combine that with a general disdain and distrust for IT, and widespread adoption of internet applications in the law industry could be a slow process.

It needn’t be. There are solutions available right now that redefine case and claim management with performance and reliability track records that put most in-house solutions to shame. These enterprise web applications are lightweight, powerful, flexible and affordable. They embody the essence of the internet and allow firms to run more efficiently, save time and money, and operate globally – with seamless data exchange between staff and their clients.

A successful enterprise web application demands an innovative approach. The software as a service (SaaS) model describes an application that is hosted and maintained by a provider who offers specific services to users, without the need for installed software on local machines. It defines the fundamental approach to how web software services are deployed, covering everything from hosting to the pricing model, typically slashing the barrier-to-entry costs and ongoing usage charges. Instead of making high initial capital investments, which then depreciate, businesses can benefit from low setup costs and put their IT budgets to a more economical use without the need for expensive hardware, electricity, maintenance and management costs.

Enter ‘cloud computing’. A broad term for a concept that encompasses SaaS but abstracts the end user away from the difficulties of maintaining a centralised system and allows for a consistent, platform agnostic, user experience. Cloud computing services are always available, instantly offering more capacity when your company grows and gracefully scaling down when there is less demand, meaning you only pay for what you use. Also, by definition, the efficiency of cloud computing makes it inherently environmentally friendly. SaaS and cloud computing go hand in hand, but they are not the same thing.

Cloud computing is a way of maintaining the infrastructure over which an SaaS application is served. It defines an approach employed by the SaaS provider. In fact, one could say, that when you look at the underlying principles, and putting technology aside, cloud computing refers to the agreement between provider and user. For example, if a provider offers unlimited file storage as part of its service, the user knows they can upload as many files as they like. If hardware requirements change as a result of this, it is up to the provider to maintain the promised service level, at no extra cost or disruption to the user, who need not be concerned about the details behind the scenes.

However, more important than the difference between cloud computing and SaaS, are the resultant features and benefits when the two are used together. These ultimately translate into real-world benefits for businesses.

We are in the middle of an economic downturn, making this a good time for IT departments to reevaluate their spending. Do they really want to use most of their budget simply making sure existing systems stay up and running? Switching to a cloud computing model will allow business to focus on innovation and strategic initiatives, rather than pumping resources into traditional software, that has not been refreshed for years.

So, what is the difference between cloud computing and SaaS? For the business end user, it simply doesn’t matter. It is more meaningful to recognise the cutting-edge features and immense potential made possible by these technologies. Clearly companies who embrace cloud computing and SaaS will be extremely well equipped to outperform less forward-thinking rivals in the future.

We’re eagerly anticipating the release of Apple’s upcoming iPad on 3rd April! Not only because we like shiny new gadgets, but because this device in particular has huge potential to streamline certain aspects of claims processing. In fact, we’ve invested heavily in getting a portable version of ClaimAble onto both the iPad and iPhone! These exciting additions to our product will be released with version 2.0 in the Summer.

When you look at the power and ubiquity of such mobile devices, in not hard to think of potential use cases when it comes to claims adjusting and management. As the world embraces mobile computing, there are significant productivity benefits for claims processing, simply from the ability to access data on the go. Staff can keep track of claims progress remotely, monitor performance, edit files, among many other things, that would previously require an on-site presence. More generally, communications with agents, contractors, lawyers and third parties will become seamlessly integrated into the workflow, and they will be able to maintain remote contact with their respective offices, submitting information that can be captured at the source, in real-time.

ClaimAble is a web based claims management application, designed to centralise the storage, processing and delegation of the claims workload. A large component of our clients’ operations involves on-site (or remote) workers – such as adjusters, contractors and lawyers – recording information outside of the office while moving from place to place. We think mobile applications, that can run on devices like the iPad and iPhone, will be key to the ongoing success of forward-thinking companies who embrace the technology.

Below are some specific potential use cases that highlight scenarios where we feel mobile computing will radically improve the efficiency and flow of data around the claims ecosystem.

The Claims Adjuster Working On-Site

A claims adjuster starts his day by checking online for today’s jobs. Before leaving home he grabs his iPad and get’s into the car. While on site, the software running on the device allows him to submit information back to HQ. He finishes the report, takes a few photos and updates the status to reflect his findings, all from on location! By the time he returns to the car, his colleagues at head office have already received the information he submitted and are busy contacting the client! The adjuster, meanwhile, is well on his way to the next job…

The Claims Handler

A new member of staff is keen to impress and has recently been working late at the office where she has access to claims files. However, with her new company-issued iPhone, she can get all the information she requires even when out of the office! In fact, the mobile application is so powerful, she can work from pretty much anywhere, and maintain control despite being at home or traveling. As a result, she can work more efficiently, with fewer time constraints and work to a higher standard. She quickly finds that this way of working is modern, flexible and highly productive.

Call Center Control Panel

A call center manager walks around the office holding an iPad running the latest claims software. He can glance down and see real-time performance reports and monitor staff productivity at the tap of a finger. A member of staff then requires authorisation for a particular claim. He opens the file, finds the relevant information and authorises the claim without having to go back to his desk!

We think the mobile computing revolution will positively disrupt how claims data is managed, providing companies with a powerful way to communicate with staff, partners, clients and contractors.

ClaimAble is coming to a pocket near you… very soon!

We’re excited to launch our new website. It’s been designed to better explain how ClaimAble works and provide a way for potential and existing customers to learn more about the product. Our new site marks a complete refresh of ClaimAble for 2010.

It’s a little late to mention New Year, but 2010 is already proving to be an exciting year for ClaimAble. Not only is our product gathering momentum and starting reach a wider (international) audience, but we will be releasing a major new update in the next few months: ClaimAble Version 2.0. This new release not only introduces new features, but represents a complete rewrite of the code and behind-the-scenes technology, including countless enhancements and improvements. We’ve been working hard on some great new features that build on the existing product, delivering some powerful new tools that will be made available to all our customers.

We will be regularly posting on this blog about new and innovative features that we’ve got in store for Version 2.0, right up until launch.

Stay tuned…