jdi data claims management & policy administration system overview
DESCRIPTION
Insurance Software Solutions Created With Your Success in Mind. Power better claims management results. JDi Data suite of claims management and policy administration solutions can help turn around your claims management and workers compensation processes.TRANSCRIPT
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JDi Data Corporation
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What is JDi Data?
JDi Data Corporation is a technology software provider and developer specializing in streamlined and efficient insurance claims management solutions and recently released policy administration.
JDi Data Corporation has been developing software solutions for over 30 years that streamlines client internal management procedures, including insurance and risk management-related processes that impact financial evaluations. Our decades of involvement in the insurance industry has helped us build a strong repository of knowledge, analysis, data gathering, and solutions development. The foundation of our mission is to develop and service in-house/cloud data systems for clients, associates, and corporate partners. We take pride in fulfilling informational objectives, providing efficient data retrieval products, and creating intelligent, readable reports.
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Claims Administration
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Claims Manager® accommodates client-driven business rules which enhance workflow.
Client/line of business rules may vary Different Client requirements for same LOB, No problem,
change set business rules for client/LOB Work flow process and triggering mechanisms make Claims
Manager® a managerial tool. Not simply a data collector, a workflow stimulator
Claims Processing – Business Rules
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Claims Manager® Main Functions
1. FNOL for all lines of product. (enter new claims, retrieve using claim no. LOB, etc.)
2. Bill Review (Review the claim descriptive data, eg CPT, ICD Code etc.)
3. Claim Adjudication (Set reserve, settle payment, enter invoices, receive explanation of benefits , etc.)
4. Payment and reconciliation of AP and AR with the carriers ERP System payee bank, payer bank, etc.
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Claim Creation/FNOL Workflow
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Claim Adjudication Workflow
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Bill review ensures competitive medical rates
Algorithms may calculate reserves based on claim type history
Kind of loss/type of loss history can assist in projecting claim value
Benefit allocation tables assist in automation
Issue automated recurring payments, both indemnity and expense
Always real time, no batch updates
Evaluation Process is Ongoing
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JDi Data System Architecture
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JDi Data Development Infrastructure
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JDi Data Development Process
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JDi Data Production Architecture
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Web based SaaS model, No maintenance always up to date!
Single database hosts multiple lines of business for efficiency
Policy Admin, underwriting, rating, billing, add as needed
Microsoft SQL database for use of established ad hoc reporting tools and ease of EDI hooks
System Delivery Considerations
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Policy Administration
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1. Clean, simple user interface to reduce the amount of user training
2. Each time a policy is bound or in force, any subsequent changes are made to a “clone” of the bound policy, to preserve a strong audit trail and facilitate the claim system integration
3. Bulk actions are implemented wherever possible to allow the user to perform an action on multiple items (such as generating proof of coverage letters) quickly and easily
4. Strongly integrated with the claim system, uses same database.
5. Permissions structure to segregate system functionality by user and/or user role
General Design Overview
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New/Renewal Policy Workflow
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Policy Endorsement Workflow
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Billing Workflow
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Claim System Integration
Traditionally, policy and claim systems rarely communicate smoothly. Adjusters often don’t have access to policy aggregates and underwriters
often don’t have access to up-to-date loss runs
JDi Data Claims and Policy Admin share a SQL database which facilitates very tight integration
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JDi Data AdvantagesComplete insurance claims software solutions.We don’t offer just claims software. We offer management solutions that help you reach your business goals. From our Claims Manager® to our Policy Administrator software, you get the most intuitive solutions available.
Reliable, fast, and loaded with advanced features.Our solutions are the result of exhaustive research and a thorough knowledge of insurance claims software needs. Each solution gives you end-to-end functionality that helps you administer, track, report, and manage your claims.
• User-defined, client-dependent configuration flexibility addresses reporting parameters
• AccessADoc proprietary document management. Easily access internal claim data and docs or retrieve externally stored Xerox and other document management systems.
• With mail merge, generate letter templates, PDF docs, form fillers for all reporting requirements.
• P&C, including Workers Compensation Software with industry standard and Custom Report Designer for simple ad hoc. Agency, broker, reinsurer, and more. Loss runs, performance, management and activity with OpticLense, functional dashboards.
• Mobile device accessibility, client portal access, multiple tier access rights, audit login trail, on line help.
• Integrate related software, Outlook email/calendar Plugin, T&E, HR and Accounting.
• OCR technology for Google type claim data retrieval.
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James [email protected]
Kevin Smith National Accounts [email protected]
2400 E. Commercial Blvd Suite 322Ft. Lauderdale, FL 33308954.938.9100 (phone)954.351.9838 (fax)
Contact Us
http://www.jdidata.com