Disability Claims Process Management
Flexible Claim Solutions Customized to Your Business
The ClaimVantage Solution for disability claims is designed to deliver auto adjudication and manual intervention at various stages in the claim process. The auto-adjudication feature is available for certain short-term disability (STD) claims ‘out of the box’. Other features include:
- Transition an STD claim to long-term disability (LTD) and/or Life Waiver claims using specific data from the STD claim.
- Provides automated workflow tasks to ensure work is completed.
- Creates color-coded fields in tasks view to show service level agreement.
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Easy to Use Claim Intake Wizard
The “Intake Wizard” guides you in capturing information needed for claim creation including standard and self defined fields including Policy, Benefit and Party. It is flexible and allows you to continue with the intake process even if you do not have all the required information. Upon successful completion of the intake process and claim creation, claims are assigned to teams or individuals based on pre-defined criteria such as geographical location or management structure.
The team structure is also configurable and is customized to meet your other business requirements.
Efficient Case Management
Your tasks and workflow are integrated into the application to ensure that the right person, is doing the right task, at the right time throughout the life cycle of a claim.
Case management is documented in the application case management journal. You can view highlights of the policy and benefit, eligibility results, tasks, claim synopsis, documents, and notes concerning medical, financial, occupational, rehabilitation, and legal.
Traceable and Clear Claim Management Communications
The Claim Vantage Solution also supports correspondence and allows you to create, save and upload documents to a claim and attach correspondence to a task so you can know what happened when and who made it happen. One important feature that is supported for Claim Examiners is the ability to create a letter using a template and to make edits and personalize the letter before it is saved and printed. Your organization has complete visibility throughout the process – all in one application.
Simple Claim Payment Processing
Payments to claimants, beneficiaries and other representatives can also be processed within the application. You can set the payment frequency to monthly, weekly or lump sum payments. Payment adjustments are simpler and changes done faster with less time and paperwork.
Faster Claim Reporting
Operational reports such as Turn Around Time, Claim Duration, and Medical Diagnosis are available to support your management team in identifying trends, resource strain, best practices, and opportunities for improvement. Additional reports vital to your organizational process are available by request, but by far the most powerful feature of the Report Writer is the ability for any user to create their own ad-hoc reports using the drag and drop feature to create and save these reports for further use.
Additional key claim processing features:
- A ‘Home’ tab that presents the user with a ‘dashboard’ view of statistics, reports, tasks, and links to application functions. This view is configurable based on your role and the products purchased such as STD, LTD, and Life.
- An Auto-adjudication and payments function for pregnancy claims (ICD9 Code 650) is supported ‘out of the box’. This allows you to concentrate your efforts and expertise on more complicated claims.
- An STD to LTD transition function which transfers key information from STD when LTD claims are created.
