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Turning Data into
Action©
By combining data from the
initial pricing study, claim data and financial data, RMG can build
databases and apply statistical techniques
to determine the areas of highest concerns. We have developed a benchmarking
process to statistically review each component of the claims process
and benchmark each activity. Results are then summarized and ranked
in importance. This new process leads to the design of focused audits
that result in immediately reducing losses. To maximize the results,
we believe an auditor should be aware of the most significant areas
for improvement before the claim files are selected for audit. This
approach maximizes savings and minimizes operating expenses by undertaking
a "measure twice, cut once" process.
Our goal is to reduce losses
and allocated expenses through the use of focused audits. This includes
reviewing the following:
- Cash management including reducing escrow
levels by reviewing loss funding procedures
- Recovering loss funds, and reducing the
incurred, from un-cashed claim checks
- Reviewing loss funding requests to ensure
that these funds are not sitting idle waiting for a claim to be paid
- Ensure that only covered claims are paid
by reviewing the coverage verification process
- Statistically benchmarking each step of
the claim process
- Review settlements, managed care, litigations,
allocated expenses to identify specific offices for focused audits
- Using systems to help identify where claim
reserves are too high, or too low
- Determine where the time to report
a claim or to close a claim is significantly increasing the ultimate
incurred
- Review account
processing including
Claims Management and administration
- Track Underwriting
results by agent, line of business and branch office
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