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Consistent Claims

To bring consistency to the workers' compensation claims process, Crawford & Company (Atlanta) launched Crawford Claims Advantage, a Web-based claims management solution powered by e-Triage (Great Falls, Va.). The system supports insurance adjusters by incorporating structured interviews into the workers' compensation claims process.

The customizable questions supplied by Crawford Claims Advantage enable the Java-based tool to identify specific risk factors that impact a worker's recovery process and create a customized medical treatment plan. "Depending on how each question is answered, it will branch off to another train of questions to cover the background of the claim," says Larry Mattingly, Crawford's vice president of healthcare management services.

Once the interview process is completed, the responses are deposited into a medical database, which leverages business rules to flag applications that contain underlying issues that may require additional services, such as investigation, medical case management or vocational case management. As a result of the consistency created by the tool, "We expect to see significant reductions in both costs and claims duration," says Bob Kulbick, Crawford's SVP, risk management services.

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