We hope these three examples will help you better visualize and understand how ClaimCompass can help your organization. The examples listed here
represent three types of ClaimCompass users - a self-administered company, an insurance provider, and a TPA.
If you have questions about how ClaimCompass can help your company, please email us at firstname.lastname@example.org, or call us at 888-512-4440.
These are not actual companies, but samples of how ClaimCompass might be used in a specific type of organization.
Miller & Sons Construction Company is self-insured and self-administered. They operate in Oklahoma, Texas, Arkansas, and Kansas. Their headquarters is in Tulsa, OK, and they have nine regional offices.
Properly reporting workers comp claims is a huge task for Miller & Sons. They use a third party claims admin software program, but it doesn’t have a front-end incident reporting tool. Most of their claims happen on job sites, which are spread out over several dozen locations, and change on a frequent basis.
MIller & Sons has four primary needs:
1) Track locations of claims, and assign the claim to the proper regional office.
2) Report a claim from any location, including locations which do not have internet access.
3) Comply with state reporting regulations to ensure they are properly reporting and to avoid potential fees.
4) Automatically import the data into their claim system to avoid double-entry of data.
ClaimCompass solves each of these problems:
1) ClaimCompass handles complex organization structures with ease. When a new claim is reported, a drop down list of corresponding locations appears based on the user’s security settings. Claims are rolled-up according to their location structure.
2) ClaimCompass offers five different ways to report a new claim. Miller & Sons takes advantage of the mobile app, which allows a site foreman to report a claim with his or her smart phone.
3) Miller & Sons doesn’t have to worry about reporting to the state – ClaimCompass takes care of sending the reports, and supports all the latest reporting requirements including EDI files.
4) ClaimCompass wrote an import application for Miller & Sons claim system. As soon as a new claim is entered it is imported into the system via an API.
On top of that, ClaimCompass sends a copy of the claim to the employee – a nice touch that helps each injured employee know they are being cared for.
Connor and Wright Insurance Services is a regional workers compensation insurance company headquartered
in Pensacola, FL. They have over 5,000 customers throughout the southeast – mostly small to medium sized businesses. They operate an in-house call center for claim intake.
Connor and Wright is looking to solve two problems:
1) Their call center is very expensive to operate.
2) More and more of their customers are asking for on-line reporting options.
This is a high priority for the executive team. They have already lost a handful of customers due to Connor and Wright’s inability to be price competitive. They have also received numerous requests from customers who wish to enter their claims on-line, as opposed to calling an operator.
ClaimCompass can help in the following ways:
1) ClaimCompass is ready fast. Connor and Wright could have their customers entering claims on-line within a matter of days. ClaimCompass doesn’t require months worth of set up time to get up and running. The organizational structure, users, and locations need to be defined – that’s it. No special programming, no lengthy project plans.
2) ClaimCompass is compliant in every state. Regardless of where Connor and Wright’s customers do business, ClaimCompass has them completely covered.
3) By off-loading some claims to the ClaimCompass on-line option, Connor and Wright will be able to reduce their call center expenses.
4) Connor & Wright can also replace their existing call center software (which is out-of-date and hard to use) with ClaimCompass. Their operators will be able to take calls faster, the data will be more accurate and complete, and the operators will have up-to-date forms to ensure they're asking the right questions.
An on-line option, reduced expenses, more flexbility in options and pricing.
Ag-Claims Management is a Third Party Administrator in Modesto, CA. They serve the agri-businesses of the lush San Joaquin Valley. They have been in business since 1925, surviving challenges as large as the Great Depression. Now as they face the future, they are trying to stay ahead of their competitors and stay on top of the growing state regulations.
Ag-Claims has three main requirements for a new reporting system:
1) Comply with California’s mandated EDI reporting.
2) Provide a reporting tool for their field reps and customers.
3) Provide a fax-in option for rural areas who do not yet have internet service.
Along with every other company in California, Ag-Claims received notice that as of November 15, 2011 claims will no longer be accepted via fax, paper, or email. All claims must be sent to the state via FTP using EDI. Ag-Claims needs a First Report solution that can help them comply with the new regulation.
Serving the agriculture industry has many rewards, but also its share of challenges. One challenge is that 95 percent of the claims they receive come from fields and farms, not offices. This requires a reporting tool that can be used remotely.
Another challenge is the rural areas that do not have adequate internet coverage. Ag-Claims needs to give their customers an option to fill out a paper form by hand and fax it in.
ClaimCompass has a solution:
1) ClaimCompass supports all three releases for EDI from IAIABC, and is a certified EDI Trading Partner with the state of California. ClaimCompass handles all aspects of the EDI transaction – from sending the initial claim, to receiving and dealing with acknowledgement files, to re-submitting the claim.
2) Ag-Claims Field Reps, and also their customers, can use ClaimCompass mobile, giving them the ability to report a claim from anywhere they have cell service.
3) ClaimCompass offers an amazing service – the ability for companies to fill out a First Report of Injury form by hand and fax it in. ClaimCompass takes that fax and keys the data into the ClaimCompass system on behalf of the customer. It’s a little more expensive, but it helps companies get all of their data into the system – even faxed-in forms.
ClaimCompass is helping Ag-Claims Management stay competitive and is helping them reach a prosperous 100th anniversary.