Claims - June 2017

In our pharmacy division, we focus on streamlining inputs and using AI to process infinite data points.

From there, we can help insurers by providing insights through real-time interfaces, as well as in more detailed reporting, so they can positively effect their claims programs. For example, we can use AI to identify an injured worker who may be at risk for opioid addiction before a risk alert could.

In this case, a claims professional would then be empowered to take a more proactive approach to the case. Claims professionals can use the power of AI to save lives. That is the promise of how technology truly enables better outcomes.

About Mitchell International, Inc.:

Headquartered in San Diego, California, Mitchell International, Inc., delivers smart technology solutions that simplify and accelerate claims handling and repair processes, driving more accurate, consistent and cost-effective resolutions. Mitchell integrates deep industry expertise into its workflow solutions, providing unparalleled access to data, advanced analytics and decision support tools. Mitchell’s comprehensive solution portfolio and robust SaaS infrastructure connect its customers in ways that enable tens of millions of electronic transactions to be processed each month for more than 300 insurance companies, over 30,000 collision repair facilities and countless other Property & Casualty industry supply partners across the Americas and Europe.

For more information, please visit
www.mitchell.com/scriptadvisor
How is your business model
changing to meet the needs of
a new generation of workers,
while continuing to serve the
needs of your clients?

Specific to the PBM business model, there are two changes that revolve around engagement. First, we have built the clinical expertise straight into the product. Just like Netflix can anticipate what movie you want to watch next, smarter product solutions anticipate challenges in the claim before they become a problem. This solves the knowledge gap for new employees but also frees them up for more meaningful customer engagement.

The second change is driven by more direct engagement with the injured party. As our business model takes a more wellness- and patient-centric approach, we are better aligned with the needs of our customers. We are able to create more solutions, such as mobile prescription re-orders and appointment text alerts, to make claims professionals more efficient as well as meeting the customer experience expectations of claimants. This ultimately delivers a better experience and drives better outcomes for all.

What do you see as the greatest challenge the claims industry will face in the next five years and how is the industry addressing this issue?

The greatest challenge and opportunity is around artificial intelligence (AI) and data. AI is already affecting the entire auto insurance model. We also see many insurers challenged by the speed and volume of available data. However, together these forces can be a powerful opportunity for our industry.

What key digital trends are most impacting insurance claims departments and how?

At Mitchell, we see the customer experience as the biggest digital trend affecting the industry today. Our customers and their claimants are interacting across channels and across platforms. There is an expectation that these engagements be highly personalized with mobile-friendly design that also delivers seamless experiences from one platform to the next.

In the Pharmacy Benefit Management (PBM) side of our business, we have incorporated these new standards with claims information and decision-making tools that can be accessed

24/7 and use visualization to help claims departments make data-driven decisions wherever they access the claim information. In the very near future, we anticipate digital trends such as tele-medicine and artificial intelligence like IBM’s Watson will change the way we all interact across the scope of medicine.