Insurance Cloud Success Stories
Road To Better Claims Data
Self-insured entities, such as municipalities, also look to cloud-based systems to help process claims against them quickly and efficiently. The city of Albuquerque, N.M., which is self-insured up to $1.5 million in claims for workers' comp and $1.05 million on general liability, was an early adopter of software-as-a-service claims processing through a system called Gensource, from Irvine, Calif.-based StrataCare, according to Alan Gutowski, finance manager in the city's risk management department. Though claims processing was done off-site with that system, there were still inefficiencies, he explains.
"With Gensource, we used to have to do batch processes every night," Gutowski says. "It was very old technology. But I don't think we've ever really housed data ourselves."
New York-based PCIS bought Gensource from StrataCare in 2010. At the time, StrataCare CEO Scott Green said he expected that PCIS would be better equipped to deliver "a next-generation, Web-based claims solution," to its clients, because StrataCare was exiting the claims management sector. And earlier this year, PCIS offered Albuquerque the opportunity to try a version of a new platform, ClaimsVision.
"Instead of us having to go out and buy a new system, we were going to get to use the beta," Gutowski says. "We've been on it since April 5."
Gutowski says that ClaimsVision makes it much easier to enter information, and data processing is much faster as well. The city uses Oracle's PeopleSoft system to make payments, and ClaimsVision better integrates with PeopleSoft than Gensource did, Gutowski says.
But as with any major system change, there are adjustments that need to be made. Because the city is a self-insured municipality, its reporting needs are different from those of a standard insurance carrier.
"I'm sure that insurance carriers don't have public information requests," Gutowski explains. "The reports that we have are good, but it's more like drop-down type selections. If we can get a report-writing function I think it will be great."
Still, Gutowski is confident that ClaimsVision will deliver what the city needs. He says PCIS has been responsive throughout the adjustment process to queries.
"They're pretty good about getting things turned around," he says. "We really have to provide better information on what the problem is. By having a good liaison I think that's really smoothed it out." -- Nathan Golia
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