Mega Claims (“Mega”) is a Third Party Administrator for insurance claims. They process business-related claims such as Worker’s Compensation, General Liability, and Property-Casualty. Patrick Elward worked with them to overhaul their claim system. Filing a claim with any insurance company is often a labor-intensive chore. Patrick reduced the manual labor needed to file (on client side) and to process (on employee side) worker’s compensation claims by 75%. With over 1200 claims being filed annually, that represents a significant cost and time savings!
“Mega” received claims via fax, telephone, written letter, and occasionally, via the internet. They realized that in order to process claims quickly and efficiently, they would need to do so via the internet. They were facing an average of 15-20 minutes for each claim to be filed online via an Adobe Acrobat form. Once received (as an email), a Mega employee would manually transcribe the data into their system, and this usually added another 10-15 minutes to the processing of each claim.
Their system had three major flaws:
1. Many fields were not filled in properly, if at all.
2. There was no room for extended explanations, which meant additional follow up phone calls or letters, resulting in lost time, delayed claims and possible misinterpretations.
3. Their data was sent ‘in the clear’ (that is, hackers could easily ‘read’ the data in transit)
Patrick developed a sophisticated online claims processing form that reduced claims filing time from 15-20 minutes to as few as 4 minutes and “Mega” employee processing time was reduced proportionately as well.
Three major improvements:
1. All required fields were filled in, with the correct data (claim would not process without this information)
2. A field was inserted for detailed explanations. This clarified claims processing and reduced miscommunication and practically eliminated follow up phone calls.
3. A secure system was implemented using SSL. This is the same technology that all banks use online. This accomplished two things: The data being sent was untouched from start to finish and the data was encrypted from start to finish. This meant no one could view or modify the data in transit.
1. All data was saved to database (previously in email only)
2. File transfer of claims from webserver to main system eliminated manual data entry of claims.
3. Dynamic follow up emails sent to client with claim number and claim adjuster information automatically inserted, eliminating 1000 follow up phone calls in eight months.
4. Data was sent securely using HTTPS (the same method used by banks)
From July of 2005 to March 2006 alone, Mega has processed over 1,000 claims online and with over 98% completion rate. In addition to the above improvements, clients were sent a copy of their claim via email for tracking purposes (without sensitive data being passed insecurely). Client feedback ranged from “A lifesaver!” to “Thank you! This is the easiest form for me to use online, it saves me close to an hour each day filing these claims!”
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