Products » Claims Automation
Regulations are constantly in a state of change. Pressure from your competition. Costs from catastrophic occurrences are sky-rocketing. All of these things are forcing insurers to find cost efficiencies in the claims cycle. Automation is part of the answer. By removing manual and redundant processes, automating proactive management, and increasing case load efficiencies insurers can protect the bottom line.
Claims Automation provides the solution for not only protecting the bottom-line but putting growth back into the bottom-line equation. Through automation we can improved process control, shorter claims cycles, and higher case loads; while improving both adjuster job and customer satisfaction.
Standard Features
To facilitate maximum cost savings and efficiencies, Everest provides a wealth of standard features, which include workflow management, automated claims, a paperless environment, automated forms and correspondence, diary notification, litigation management, extensive reports, executive dashboard, a full role based authority engine, online policy verification, deductible processing, 1099 processing, and full claims financial and payment processing. Claims Automation is accessible from any web browser and has a full-featured rich client interface.
Paperless Environment – The document and image management system enables a fully paperless claims process. Everest supports attaching word documents, spreadsheets, PDFs, emails, and other electronic documents as well as scanned documents. Image and document queues allow mail to be processed and indexed directly to claim files. Document and bill images are available directly in the claim file, and the document mailbox allows the user to work all their mail in one place.
- Easy to learn user interface
- Automated claims
- Automated alerts and monitoring
- Integrated document management
- Automated forms
- Litigation management
- Case management
- Executive Dashboard
Workflow & Business Rules – The Everest workflow engine provides process automation, and the business rules engine enforces your organization's best practices. Everest’s Claims Automation allows you to customize and control claim processing based on individual claim characteristics. Simple claims, such as medical only or auto glass, can be automatically processed; while more complex claims can be setup with specific diary settings and automation processes and routed to the right claims personnel for processing. The security engine allows for user and role based security and authority to be defined. Claims processing can be tailored to each organization and each individual claim, enabling an on-going refinement and perfection of business process automation.
Reserve Management – The system facilitates full reserve processing and management including reserving authorities, approvals, history, reserve worksheet, and granular tracking and management of reserve bucket components.
Payment Processing – Claims Automation provides full payment processing functionality, which supports automated payments, scheduled payments, recoveries, refunds, voids, reversals, stop pays, check printing, 1099 processing, payment transfers, and authorized payments on closed claims.
Automated Claims Assignments – Using the business rules engine and workflow engine, the system can automatically assign adjusters, managers, case managers, and other claims personnel to the claim.
Automated Claims – The system can automatically setup, process, and complete claims of specific type and characteristics. Claims that benefit from full automation include high volume/low cost claim types such as auto windshield and work comp medical only.
Claim Automation also includes Litigation Management, Document Management, State Forms, First Notice of Loss,and Reporting. Here are more highlights from the feature list...
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