claims options overview brochure
DESCRIPTION
ClaimsOptions overview of claims quality management services and software solutions.TRANSCRIPT
Consulting and Software Solutions
PlanPlanPlan
AssessAssessAssess
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ImproveImproveImprove
THE DESIRE FOR CONTINUED IMPROVE-
MENT IN PROCESSES AND OUTCOMES
IS A KEY DRIVER IN CLAIMS ORGANIZA-
TIONS. MOST INSURANCE CARRIERS
COMMIT SIGNIFICANT RESOURCES TO
MANAGING QUALITY. HOWEVER, THEY
FIND THAT THEIR EFFORTS ARE NOT
PRODUCING DESIRED RESULTS.
CLAIMS OPTIONS’ SUITE OF SOLU-
TIONS TAKES ORGANIZATIONS’ DE-
SIRED OUTCOMES AND TURNS THEM
INTO ACTUAL, MEASURABLE IMPROVE-
MENT.
CLAIMSOBSERVER™
IMPROVEMENT DRIVING SOFTWARE
Quality Management efforts are central to the success of your
operation. ClaimsOptions wants you to understand the WHY
behind your quality issues.
WHY:
Have previous efforts not produced the desired effect?
Has training not produced measurable improvement?
Are you still struggling with the same issues after
taking corrective action?
Less than 50% of insurance companies surveyed use quality data
in strategic planning.
Our research has shown that 70% of quality assurance practices
produce little or no improvement.
Working with ClaimsOptions..
ROOT CAUSE ANALYSIS
IT IS IMPOSSIBLE TO ACHIEVE MEAN-
INGFUL QUALITY IMPROVEMENT
WITHOUT UNDERSTANDING ROOT
CAUSE. CLAIMSOPTIONS’ TEAM OF
CLAIMS MANAGEMENT EXPERTS ARE
FOCUSED ON HELPING YOUR ORGAN-
IZATION IDENTIFY THE ROOT CAUSES
BEHIND THE PROBLEMS YOU ARE
FACING, SO YOU ARE ABLE TO AFFECT
IMPACTFUL CHANGE.
ClaimsOptions’ team of experts takes a full cycle approach to
quality management. We know that simply identifying errors does
not fix them. This is why our full cycle approach, which identifies
the root causes of organizational problems, enables us to imple-
ment solid techniques to find solutions and impact measurable
change.
No organization can implement long-term positive change without
having a solid quality management platform. Our unique combi-
nation of technology and professional services ties key measures
and root causes to help you break through performance ceilings to
significantly increase the positive outcome of quality improvement
measures.
A Total Quality Management Strategy establishes standards to be
measured against. Our quality management process is calibrated
to improve consistency in measurement. Identification of root
cause enables action plans to be created for long-term and impact-
ful change. With ClaimsOptions’ Quality Management Approach,
you’ll know WHY your organization needs to implement full cycle
change to achieve the desired results.
BENEFITS
FOCUS ON INFORMATION, NOT INFRA-
STRUCTURE
FAST AND EASY DEPLOYMENT
NO SERVER REQUIREMENTS
NO CAPITAL EXPENDITURES
NO IT MAINTENANCE/SUPPORT COSTS
BUILT ON A PROVEN PLATFORM
ALL YOU NEED IS A BROWSER
ClaimsObserver™, a performance improvement software, is developed to
assist companies in building a solid quality management foundation to link
key measures and file outcomes. This systematic, proven approach to quali-
ty management helps organizations to gain a firm understanding of the root
causes behind performance issues.
ClaimsObserver™ helps to improve accuracy, decrease cycle times, improve
efficiency, and ultimately improve customer satisfaction in your claims or-
ganization with the most complete, easy to use and cost effective quality
management solution. ClaimsObserverTM enables you complete the full cy-
cle of improvement, so you can move beyond quality assessment to effective
quality management.
Benefits include:
Easy Customization
Flexibility
Outcomes Based Observations
Root Cause Identification
Real Time Results Measurement
SAAS MODEL
HOSTED SOFTWARE SOLUTION
Claims management teams are continually being challenged to reduce claim
cycle times, ensure accurate payments, reduce leakage, improve customer
satisfaction and control costs. Many quality assessment initiatives fail to
lead to improved outcomes.
That is where ClaimsOptions™ comes in. We work to ensure that your next
quality initiative produces measurable improvement and helps you to make
changes, which produce long- term results.
We’ll help you:
Build programs, which align your team with high quality outcomes
Improve current performance results with independent quality review
Improve your team’s capabilities to develop and execute effective
strategies using root cause analysis
We help you to identify the WHY behind your problems, and we work to-
gether with you to create solutions.
QUALITY MANAGEMENT
A NEW APPROACH
TECHNOLOGY ALONE DOES NOT DRIVE
PERFORMANCE. PEOPLE DO! CLAIIM-
SOPTIONS’ PERFORMANCE TEAM CAN
HELP YOU DESIGN PROGRAMS THAT
LEVERAGE EACH STEP OF A FULL CYCLE
QUALITY MANAGEMENT PROGRAM.
OUR RESEARCH SHOWS THAT TRADI-
TIONAL, COMPLIANCE ORIENTED AP-
PROACHES TO QUALITY MANAGEMENT
ONLY PRODUCE MODERATE IMPROVE-
MENT. CLAIMSOPTIONS APPROACH
FOCUSES ON ADDRESSING CRITICAL
PROBLEM AREAS TO REACH A HIGHER
LEVEL OF IMPROVEMENT OVER A LONG
-TERM CONTINUUM.
David Young, President, Co-Founder
David Young is the President of ClaimsOptions™. Dave is an expert in claims operations, inter-
nal audit and quality management implementation. His expertise in building successful claims
operations, implementing quality programs and leading company-wide technology and pro-
cess change enables him to assist claims organizations with quality-driven improvement. Da-
vid founded ClaimsOptions™ to introduce process improvement and quality management so-
lutions to the industry at large.
Dave’s direction and leadership in designing audits for large property and casualty insurance
carriers transformed the definition of quality management. He has built and deployed proven
audit technology solutions, which have been impactful in driving improvement. David is com-
mitted to helping you to find the root cause behind your quality control measures. Both the
software solutions he has designed and the consulting services he offers, focus on that core
mission.
Jim Kaiser, Executive Vice-President, Co-Founder
Jim Kaiser is the EVP and Co-founder of Claims Options. Jim has over 20 years of experience in
the Property and Casualty Insurance Industry. He has worked in claims operations for one of the
largest insurance carriers in the US. Jim’s expertise in managing claims field and staff adjusters,
leading audit and quality control programs, and implementing total quality management proce-
dures enables him to assist other quality driven organization in effective change implementation.
Jim has spent over a decade leading strategic efforts designed to improve claims quality. He now
combines his experiences to help claims leaders elevate their performance.
ClaimsOptions™ - Consulting and Software Solutions
Contact ClaimsOptions™ today for a demo! Call 970.231.7668, or Email: [email protected] www.claimsoptions.com