How to Spot an Effective Claims Management Process


What an Effective Claims Management Process Looks Like

In our last post, we uncovered 6 signs your claims management process is outdated and is likely costing you time and money—and is causing major frustration, too. 

In this article, Brad Brown, iReportSource cofounder and VP of Sales, walks us through a few of the key components of a proactive, modern‚ and more effective approach to managing your workers’ compensation claims. 

This is What an Effective Claims Management Process Looks Like 

Here are 6 components of a modern, effective approach to managing claims: 

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1. The process is standardized & consistent

Many employers—for a variety of reasons—are unable to keep up with some, if not many, of their claims. Many times, different departments are involved or competing priorities get in the way of staying on top of claims.  

No matter the reason, the result is that claims are not dealt with appropriately and they are not stayed on top of in a timely manner, explains Brad. (These are really two different issues, but they can happen as a result of a paper-based, or e-mail intensive, outdated way of managing claims that isn’t consistent each time.)

The problem is that first part of the claim, the allowance, is critical to what happens afterwards. “The more time that passes, the more it can cost your organization. I have read that the average lag time for an employer in the U.S. is 2-3 days, but with a digitized program like iReportSource, you can have taken that down to on average around 4 hours or less,” explains Brad.

Successful claims management processes are built upon a standardized, consistent way of managing claims, and that process is in place before any incident ever occurs.

Standardization in your claims management process should be across five areas, at minimum:

  • How you collect information and evidence for your claims 
  • How you ensure individuals receive appropriate medical treatment 
  • How you empower the individual to get back to work 
  • How you communicate (within your company and with the worker) 
  • How you implement measures to prevent future incidents/accidents

A tool like iReportSource drives consistency in the way that information is going to be gathered, which helps to support that desired standardization, and resulting timeliness in the overall process, says Brad.  

The investigation may include information such as the date, time, location, details on those involved, witnesses, environmental conditions, key circumstances leading up to the incident, and many, many other factors. 

That’s a great deal of information, but iReportSource prompts and “cues” a worker through questions so all those details can be gathered—and that’s right after an incident (or near miss) happens. Having all that necessary data (pictures, interviews, audio, text and more) is then critically important as you examine root cause. 

2. The process inherently holds people accountable

claims management should hold workers accountable

Successful claims management processes allow employers to see progress in real-time, and that means employees are more likely to also take ownership of the process. Thanks to tools like iReportSource, employers can see—in real-time—how claims are being addressed at any and all stages of the workers’ compensation process. 

The traditional way claims have been managed doesn’t necessarily hold people accountable since information wasn’t as visible, and since collaboration wasn’t made simple. All the paper-chasing, countless “copy all” e-mails and passing off of responsibility meant accountability suffered, but that no longer has to be the case.

3. The process allows for collaboration 

Speaking of collaboration, effective claims management processes are structured in a way where employees can gather all the pertinent information, and they can get team input, quickly and correctly – every time.

With a program that is digitized, it should allow all stakeholders to truly collaborate with one another in real time, thus reducing the “chasing paper” and “endless e-mails” dilemma we often see in the workplace.

4. The process can help you reduce risk in the future

As unfortunate as near-misses and incidents are, your claims management process should help you leverage that data so you can improve safety and reduce risk in the future.

you should leverage near miss data to improve safety

You also want to be able to be strategic thanks to your claims management process, versus being tactical or “in the weeds”…or quite literally, in your spreadsheets!

Effective safety management systems can give you real-time performance dashboards that pull in all the data you need, no matter how many divisions or departments you’re working with.

That means you can have report metrics or scorecards on-demand, right when you need them, and right when they are most useful to your organization. Organizations that do this well will be able to have data that clearly tells a story, and they won’t have to spend hours and hours in spreadsheets just to get the information they need during the claims process.

Safety leaders will also be able to show what the outcomes are, and then how it impacts and/or benefits workers in the organization. It’s a standardized, efficient way to finally be able to put your safety data to use so you can improve safety, which is really what this is all about, explains Brad.

5. The process should save you money

The direct and indirect costs of managing a safety program and workers’ compensation claim are high. When you factor in the amount of time allocated to managing those programs in a traditional setup, the numbers become unsustainable for most businesses.

For many employers, technology like iReportSource is easing the entire process, resulting in major time and resource-savings. Not to be forgotten, it should also help you get employees back to work. “Remember, time is the enemy in the world of workers’ comp claims. If your process gets an employee back to work sooner, or if the process resolves their situation sooner, it become a win-win for all parties,” says Brad.

consistency is key in claims management process

6. The process should help you reduce fraud

There are two key ways to reduce workers’ comp costs: preventing incidents from occurring altogether (so your culture, incident and near-miss investigation, behavior-based safety practice) and then controlling the costs if an injury does occur. When you have consistency and standardization—consistency in your process and consistency in your application—you help to control such costs.   

An Effective Claims Management Process Helps You to Continue to Improve Safety

All in all, employers ought to have a consistent way to take care of the people who need to be taken care of, and a way to use any available safety data to improve in the future. 

Brad says this is really about putting power in employees’ hands so that they can be involved and engaged with safety, and in making the claims management process more efficient and effective.

“What that really looks like is a culture where every employee matters. By having a system in place where you are capturing valuable information from the front line work, you are doing that. It also makes the employee feel like they are a part of something, and they can tell their employer cares about their health and their well-being,” says Brad.

Improve Your Claims Management Process with iReportSource

With iReportSource, you can move from fault-finding to fact-finding in order to improve your company’s performance, culture, and the bottom line. iReportSource is the easiest and most affordable way to get your safety program online and into the hands of your employees. Make your entire claims management process more effective, streamlined, and standardized with iReportSource. Learn more today.

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