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Scott R. Smith and Ajit Viswanathan, Mitchell International
Scott R. Smith and Ajit Viswanathan, Mitchell International

Improving Claims Management With Advanced Integration

The technology improvements achieved through advanced integration can boost adjuster efficiency, empower better decisions, and deliver a better customer experience.

Advanced integration is a large, complex process that involves core claims management systems and expert point solutions. Core claim systems and expert point solutions historically have been loosely integrated, which has resulted in issues such as lengthy implementation cycles, inefficient claims processing and the inability to use data assets from various systems. Times are changing such that advanced integration of these large and complex processes can be achieved when organizations partner together and leverage technology to achieve a single user environment.

Scott R. Smith, Mitchell International
Scott R. Smith, Mitchell International

[More than half of insurance carriers are planning some level of replacement of their claims system this year, reports Celent's Karlyn Carnahan]

There are multiple benefits of advanced integration for the Property & Casualty (P&C) insurance industry. These benefits include appropriate single-user environments, optimized claims handling processes, application of multiple data assets for improved alert capabilities, and enhanced task automation opportunities. Let's explore what advanced integration might look like from a technology perspective and how specific technology advances and feature enhancements will benefit the P&C insurance industry.

Single-User Environment

For insurance adjusters, one painful reality of their job is the need to switch between multiple software systems in order to find all the relevant information on a specific claim. It's critical to have all pertinent data in one spot to reduce and/or eliminate this quest for data. By creating a seamless user interface, adjusters can quickly access the information they need.

Ajit Viswanathan, Mitchell International
Ajit Viswanathan, Mitchell International

Through deep integration of expert point solutions, adjusters will be able to access a robust set of data on one screen, eliminating the need to toggle back and forth among various applications. Having screens embedded into one application makes data available to adjusters when they need to quickly make educated decisions.

Advanced integration helps to alleviate this industry pain point by bringing data from various places into one cohesive ecosystem. By implementing this type of integration solution, P&C carriers can access embedded analytical capabilities and leverage this wealth of information in their decision support systems.

Data Integration

In some cases, the transfer of data from one system to another occurs in a batch format, which sends flat files at standard intervals. Since data is delayed until the next scheduled transmission time, adjusters do not have access to real-time information.

One technology improvement resulting from advanced integration is the application of a common format of data exchange. That way, data can be routed to the appropriate expert point solution. Advanced integration enables real-time data transmission through web services, which are used to get more information from the claims system into the expert point solutions. When data is received at a quicker rate, adjusters can use that valuable information to react much faster and process claims more easily.

Data integration is also useful during the payment portion of the claim. A multi-directional flow of data exchange helps to expedite paying providers, since the payment information is readily available. Faster payment to medical providers helps to increase provider satisfaction and decrease payment inquiry phone calls or resubmission of invoices, allowing adjusters to focus on more important tasks.

Data mining is another benefit of advanced integration. By leveraging data mining capabilities, P&C adjusters and their managers are able to get a more realistic picture of potential problems and can receive alerts in plenty of time. When important data is located in various systems, adjusters aren't able to see potential problems in a timely manner. Advanced integration helps to provide a deeper understanding of what's occurring, and offers the means to take action early on so that problems can be reduced or eliminated.

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