FINEOS Introduces Its Workers' Compensation Claims Solution to U.S. Market

FINEOS Corp. (Dublin) has its new FINEOS Claims for Workers' Comp product to manage claims for workers' compensation claims in the US. While the company's workers' compensation solution already is in use in other, non-U.S. markets, this new product has been developed to address the specific requirements of the US market " which is characterized by complex multi-state compliance and reporting requirements.

FINEOS Claims for Workers' Comp offers insurance carriers, TPAs, self-insureds, state funds and other government entities complete claims lifecycle management, including intake, payments, reserves, provider management, and other claims processes, according to the vendor. It includes rules and workflow capabilities that are flexible enough to easily accommodate changes to product definition, U.S. regulatory requirements and internal processing policies, FINEOS says, as well as a powerful case structure, which is vital for managing workers' comp claims, where multiple parties are typically involved (nurse case managers, medical staff, claims handlers etc).

Capabilities developed specifically for the U.S. market include preconfigured business content in areas such as compliance, fraud detection and medical management. In addition, it can integrate with decision-support databases to help organizations evaluate claims status against accepted rehabilitation timeframes.

According to Michael Kelly, FINEOS' CEO, "We believe that this is an underserved market that will benefit from the world-leading capabilities that FINEOS Claims can offer. U.S. workers' compensation is also an industry with significant environmental issues including medical inflation, indemnity costs, and regulatory challenges. Using FINEOS Claims will enable carriers' and state funds' efforts to offer a claims service that is consistent and transparent, ultimately creating mutually beneficial outcomes for employers, providers, workers' compensation writers, and injured workers," he said in a press release.

Katherine Burger is Editorial Director of Bank Systems & Technology and Insurance & Technology, members of UBM TechWeb's InformationWeek Financial Services. She assumed leadership of Bank Systems & Technology in 2003 and of Insurance & Technology in 1991. In addition to ... View Full Bio