Three Things Every TPA Should Know About Risk Management
Sep 09, 2022
Knowing your customers is critical to success in just about every business, and third-party claim administration is certainly no exception. In many situations the path to obtaining this knowledge is clear, but those paths have limitations. The greatest added value can come when a service provider identifies needs that the customer may not even be aware of, yet would greatly benefit from addressing.
We offer three insights that can benefit both the third-party administrator and its customer.
Point One: Introduce Your Customers to Workflow Management
Whether it be within the TPA’s own operation or that of its customers, there’s a tendency to revisit the same issues many times over. The likely result is small reactive improvements to current processes. Real-world constraints or resource limitations, like limited bandwidth or lack of management buy-in might stand in the way of doing things differently.
Workflow management is a prominent way to break through these obstacles. It represents a better way of doing (and expanding upon) repetitive tasks, using technology to replace manual steps while making new connections. The right workflow management tools foster new levels of collaboration while connecting data in new and creative ways. The benefits include reduced lag time, dramatic efficiencies, better case outcomes, new analytical insights and lower total costs.
Point Two: The Right Risk Management Information System (RMIS) Benefits the TPA and the Client
It can be shocking to learn how much of a difference the right risk management information system can make. Along with benefits for the insured, such as lag time reductions approaching 50% and dramatic cost efficiencies, the claim administrator will realize its own benefits, like more complete and accurate information. However, this requires partnering with the right technology platform; yesterday’s claim repository system won’t get you there, because they often lack flexibility and connectivity
A before-vs.-after review of customers who have adopted Aclaimant’s workflow management tool indicates that adjustor caseloads can be increased by 6-9% due solely to the shorter time to closure of cases reported on the Aclaimant platform. Indemnity-vs.-medical-only case mix improves by some 4%.
How do these things happen? Customers with state-of-the-art workflow management tools within their RMIS deliver cleaner data to their claim administrator, with dramatically less lag time. Adjusters spend less time compiling data and resolving basic issues from external sources. With cases reported faster, it’s less likely that bad decisions and unwanted claimant behaviors have already taken place. And, the insured is better prepared to act on advice and information requests.
Point Three: Select Your Partners Carefully
Many technology vendors either have ownership roots that pose a potential competitive threat or have larger business interests that can conflict with those of the TPA. As alluded to before, some technology vendors may be too small or niche-oriented to be scalable or provide the necessary connectivity from the insured to the TPA claim administrator. Others may deliver on their promises but at a prohibitive cost or with an implementation timeline that risks alienating the customer.
The right firm will respect the interests of its business partners yet have the flexibility and resources to deliver solutions that address specific customer needs even when customization is necessary. It will deliver its services on time and as promised, with a transparent and acceptable total cost. And it will have the insight to see things differently and identify new opportunities.
If your prospective vendors don’t measure up, or if you want to introduce your customers to new ways to succeed, it’s time to talk to Aclaimant. Visit us at Aclaimant.com or schedule a demo for additional information.