formation within the organization?
7 Managing the complexities of tracking requests. Track how claims information is shared outside of the organization. It
is imperative to monitor the turnaround
time for all requests. Reporting should
have the capability to electronically track
the life cycle of each request.
8Reporting. Tracking turn- around time on completing requestsandsupportingclaims management processes is a
must to ensure the staff is abiding by
the organization’s standards. Improving
turnaround time can significantly increase efficiency in managing claims.
9Establish security standards. The organization must have physical, procedural, and elec- tronic safeguards in place to
ensure the security behind the claims
management and data request processes.
• Physical safeguards — What are the
physical measures the organization has
in place to manage, monitor and protect claims data and information?
• Procedural safeguards — What are the
procedural checklists, documentation,
standards of procedures, protocols, and
workflow documentation in place to
safeguard the processes and claims in-
formation? Be sure to implement a pro-
tocol for security incident reports. It is
important to know how to escalate and
address claims information that was
improperly shared and how to manage
that escalation process.
• Electronic safeguards — The IT “must
haves and must knows” as they relate
to claims files and sharing information
with third parties.
10 Prioritizing requests. Does the staff know how to prior- itize requests? Requests for copies of claims files are inherent in the claims management process.
How are you ensuring they are compliant
and timely? It is imperative to pay careful
attention to subpoena deadlines, internal
requests (i.e., arbitration, litigation, and
subrogation) and external requests (i.e., attorney, adverse carriers, third parties).
Approximately 30 percent of data
breaches are due to personnel errors. By
establishing specific guidelines and procedures, training employees and developing security standards, companies can
reduce the risk of incorrectly releasing
confidential information and creating a
Fig Gungor has been the chief executive
officer of ClaimFox for the past 11 years.
She is responsible for the strategic
direction of the company, leads new
business development, and oversees
several national and regional accounts.
Spartan Recoveries understands the obstacles in managing a successful
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