Creating a Claim: Capturing the Essentials

Thursday, May 3rd, 2012

Get the right information. Right away. It seems simple enough, but without the right information about a claim–entered correctly–any process is going to start in the hole and have a hard time catching up.

There are a lot of ways to get information about a claim. It may come from an intake form, information gathered over the phone, sent over from another department, or from a third party. Whoever that claim is assigned to is going to either work with the information they have, fill in extra information, or start all over again to make sure the claim information is valid.

The ClaimVantage solution for creating a claim in the system is set up to make sure that the information that goes in is the information you need to adjudicate the claim. If you’ve watched any of the videos on our website, you’ll hear us talk about the intake wizard and reflexive questions.

Creating an online claim using reflexive questions

Capturing critical claim details using ClaimVantage's Wizard and reflexive questions. (click to enlarge).

The wizard is accessible though any enabled web access portal and simply takes you through a series of reflexive questions. The questions are set up based on your business requirements and simply make sure you have the right information to initiate a claim in the solution.

What’s the difference between a reflexive question and just a question?  A reflexive question requires an answer that makes the person answering consider their knowledge of what’s being asked before answering? For example, on a disability claim you might ask whether an accident happened at work, but you usually would not ask if a pregnancy happened at work!

We use these types of questions–related to the type of claim of course–to make sure the information that starts a claim is accurate, complete and easy to enter.


Posted in Claim Automation, Claim Management Best Practices, Claim Management Software, Cloud Computing, Technology | Tagged , , , , | Leave a comment

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