All new technologies and innovations will need to take their
place alongside the integrations we already know so well in
workers’ comp, including EDI, bill review, document production
and the like. New technologies remind us that integrations are
essential not only in the intake phase, but throughout the claims
process for both current and future systems.
Best practices and planning
Setting expectations and executing proper preparations up
front will make the integration process easier. First, make
sure the organization is internally ready for the integration
process. Here are a few steps organizations should go through
Define the value that the integration can bring to the organiza-
tion and the goals you wish to achieve. For example: Expanding
in the market, increasing regulatory compliance or providing a
better customer experience.
Make sure all key decision-makers and executives are involved
in this process to ensure alignment to the organization’s strategic
goals with the tactical implementation of the integration.
After understanding the organization’s goals, examine your
own in-house expertise and technologies to determine strengths
and identify any potential gaps upfront.
After completing the value and resource assessment, evaluate
what expert systems vendors can help improve the systems and
processes. In the end, handling the due diligence and planning
up front and then selecting a qualified partner to integrate with
improves an organization’s chances for a successful integration
that will improve their claims processes.
Choosing the right partner
Just like in life, choosing the right partner is integral to the success of the integration. Here are some important characteristics
to consider for the selection process.
• Partner characteristics
Adherence to technical and data standards
• Level of expertise
• Willingness to listen
It is also important to thoroughly evaluate the software system
that will be integrated with the claims system. Here are a few
areas to consider during this phase of the process:
• Partner software characteristics
• Footprint in the market
• Ability to integrate
Creating a well-thought out plan and process for systems integration is just as important as creating a blue print when building
a house. Defining what you want in advance, aligning key stakeholders and choosing the right partner will lead to a successful
integration that can help organizations improve claim efficiency
and overall outcomes.
Bill Morgan ( BMorgan@guidewire.com) is a claims solution
consultant with Guidewire Software. He provides critical industry
knowledge to support Guidewire ClaimCenter’s Worker’s
Compensation line of business and has served the insurance
industry for over 25 years. Rebecca Morgan ( Rebecca.Morgan@
mitchell.com) is senior director of product management for
Mitchell’s Workers’ Compensation Solutions. Her teams are
responsible for both medical bill review and claims reporting
software deliveries for the workers’ compensation market.
ACHIEVING A SEAMLESS AND ACCURATE CLAIMS
PROCESS STARTS WITH A WELL-THOUGHT-OUT
SYSTEMS INTEGRATION DESIGN PLAN.