How to Evaluate the Right Claims Management System for Your Organization?

With continuous changes to the software industry, Claims Management Systems (CMS) have evolved with technology. These systems are equipped with newer capabilities to provide enhanced services to customers. In such situations, evaluating and selecting the right CMS for your organization could be a difficult task. In order to assist with this process, we furnish a few simple steps through which you can evaluate and choose the right CMS for your organization.

Check the efficiency and responsiveness of the system:

Efficiency

• Claim management systems are crucial to making the customers satisfied and to improve the overall performance of the company. A CMS should be able to manage the entire claim process – from the beginning to the final settlement. The software should help in organizing every file activity and maintain reports.

Responsiveness

• In addition to performance, a CMS needs to allow the user to run reports instantly. The ability to quickly access information will expedite the claims, allowing employees to return to work, and employers to save valuable resources.

• A transaction – accessing and saving a claim, creating letters, etc. should not take more than 10 seconds, and on an average it should be done only in a couple of seconds.

• While evaluating the performance and response time of the CMS, ensure to check them in a real time environment with and user data. This will give a complete picture of the performance and the responsiveness of the system.

Technology used in the system

Today, many organizations prefer browser based systems that help them simplify deployment, support, and allow for remote access.

• While evaluating the technology, check the type of database being used. It is important to choose the right database with a simple and efficient data model. This will help create reports and data mine independently.

• A critical issue that goes unchecked by many organizations is with respect to the reporting database. The reporting database should be kept separate from the transactional database as it impacts the system performance.

Security, confidentiality and hosting model of the system

Security and confidentiality of the data

It is the responsibility of the organization to keep the claimants information secure. In order to keep the data safe, it has to be encrypted with multilevel access passwords. All users should be given unique ID’s and passwords with no plain text.

• To reset the password and protect system security, do not allow viewing of the old password.

• Data to the user and from the user should be encrypted using a SSL encryption. Along with this, user access permissions, levels of authority, hierarchy, etc. – are necessary to ensure security and confidentiality.

Hosting

• If your organization possesses adequate bandwidth and infrastructure for supporting new applications you may want to consider hosting the system.

• If not, hiring a reputable web host is you best alternative. Be sure to confirm the system is always accessible and is supported without any interruptions in the services. Additionally, in choosing a web host make sure that there is equipment redundancy and document backup to ensure data is replicated without any loss.

Functionality and features of the system

Functionality

• For every CMS, there should be some basic functional modules such as claim/claimant maintenance, notepads, diaries, reporting, payment and reserves, etc.

• Check the functionality that will help the examiners to focus on closing claims quickly. You can ask various questions regarding the functionality of the CMS, depending on your business requirements and workflow.

Features

• Check the features of the system and all the data categories that your organization needs.

• The system should enable users to build data fields as the organization grows and risks become more complex.

• Check for the software integration. This gives the new capabilities in settling the claims quickly and efficiently.

Vendor assessment

Once the system meets all the required guidelines, it is necessary to assess the vendor. In order to assess a vendor, several factors should be considered.

Clients’ needs

• An efficient vendor should constantly work on improving the system, based on client needs. They should be to discuss new functionality and any challenges with implementing system enhancements. Ask any potential vendor how often they meet their clients for discussing such issues.

Other factors (past experience, etc.)

• Consider vendors past experience. How efficient they are in research and development of new technologies? How effective are they are in knowledge transfer?

• References would assist in choosing the right web host. This will provide appropriate insight to what a relationship with the vendor will be like in the future.

Pricing structure

• Pricing structure should be flexible for each client. Depending on size and need, each contract can vary greatly. Terms of payment should also be flexible in order to allow companies of all sizes to find a system that works for them financially. A CMS with many users should cost less per user than that of one with fewer users.

Following these points can help evaluate the claims management system (CMS) quality parameters, and check how well it suits your business.

JDi Data Corporation is providing insurance claims software for 30 years. The product suite includes workers compensation software and claims management systems for property and casualty, medical malpractice, risk managers, third party administrators, etc. JDi Data has built a reputation in quality claims management software with emphasis on complex litigation.

Article Source: http://EzineArticles.com/expert/Steven_M_Richard/1385140

 

Leadership Lessons From Andrew Carnegie and Glenn Holland

A reporter asked the great American industrialist, Andrew Carnegie “how he managed to hire 43 millionaires?”

Mr. Carnegie responded ” that none of them were millionaires when I hired them.” When asked how he developed them he said, “You develop millionaires the way you mine gold. You expect to move tons of dirt to find an ounce of gold, but you don’t go into the mine looking for the dirt-you go in looking for the gold.”

Andrew Carnegie knew how to select his winning team. Zig Ziglar says you need to, “Be a good finder” and Mr. Carnegie was a “good finder”.

Mr. Carnegie wrote in his Autobiography “The development of my material success in life can not be attributed to what I have known or done myself, but to the faculty of knowing and choosing others who know better than myself.”

What are the 3 ways Andrew Carnegie hired his team members?

1) He chose experts in the steel business.

2) He embraced diversity for his team members selecting people on their skills, personalities, business experience, and believed if you had the expertise he was looking for that your age or gender didn’t matter. Mr. Carnegie wanted the best members for his team.

3) Mr. Carnegie was willing to “learn and listen” to the people he was leading.

Andrew Carnegie said, “I did not understand steam machinery, but I tried to understand that much more complicated piece of mechanism- man.”

He also said, “As I grow older I pay less attention to what men say. I just watch what they do.”

Throughout his life he was “an avid reader”. As a young bookkeeper, he was invited on Saturdays to go to private libraries of well-off citizens to read and learn from their collections. Once he had achieved success, he gave back by assisting in the building of “three thousand libraries” for young people to have appropriate books to read.

Carnegie-Mellon University was built by Andrew Carnegie, as was Carnegie Hall in New York City, the most famous concert hall in the United States. He also donated over $350 million dollars to his public foundations, and awarded grants annually “to benefit the public”. His foundations continue to give to worthy recipients each year. In 1999, his Carnegie Corporation of New York was valued at over $1.55 billion even after grants had been given continually of “millions of dollars”.

In the movie “Mr. Holland’s Opus”, Richard Dreyfuss plays Glenn Holland, a musician and composer who takes’ a job as a high school orchestra teacher to support his family. His dream was to write a great symphony. Over the course of 30 years, Mr. Holland evolves into a caring, compassionate teacher who inspires, motivates, and encourages his students to “love learning”. He worked diligently with them and was willing to go the extra mile to make a difference. Mr. Holland was determined to educate his students and have them grow into fine young men and women who would be able to study, work hard, and think clearly to reach their goals for their futures.

In his 30th year of teaching at the high school, the music program is being phased out, and Mr. Holland will no longer have a job. As he’s getting ready to leave the school for the last time, he hears sounds coming from the auditorium. When he goes into the auditorium he sees his former students on stage with their instruments getting ready to play the music on their stands. Sitting in the filled auditorium are his wife, son, fellow teachers, and more former students he has helped to educate over the years. He is asked to take the baton and conduct his symphony for the concert.

Mr. Holland’s “true symphonic masterpieces” were all his former students that he shaped and groomed over the years to be fine young men and women who would go on to reach their goals and help others reach them, just as Mr. Holland taught them to do!

What 3 things did Mr. Holland teach his students that benefited them through their life’s journey?

1) He taught his students the joy of learning by making it fun and exciting to learn. He showed them with a positive attitude how to focus and concentrate on the work and how to enjoy working with others. He taught them using “the Learning by Example” approach.

2) He taught his students by encouraging, motivating, and inspiring them to do their best work. He was always kind, patient, and compassionate with each student and they knew he cared about them and believed in them. He removed roadblocks from their path and made each of his students believe in themselves. He was always willing to spend the extra time explaining a difficult concept until the student understood the material, giving them self-esteem and self worth.

3) He taught his students to never give up and how to work step-by-step to do their very best work and to be able to think clearly and concisely.

So what three things should you do to develop your winning team at your company or school like Andrew Carnegie and Glenn Holland?

1) Throughout his life Andrew Carnegie was “an avid reader”. Never stop learning and always continue to develop your mind by studying and reading to gain new knowledge every day.

2) Glenn Holland showed compassion and dedication to helping his students understand the material by explaining it step- by-step in a clear and concise manner. Jackie Robinson said: “A life is not important except in the impact it has on other lives.”

3) Andrew Carnegie developed his team members by mining the gold in each of them. Glenn Holland like Andrew Carnegie developed his students by mining the gold in each of them.

Benjamin Franklin asked himself each morning “What good shall I do today?” And before he went to sleep at night he would ask himself “What good have I done today?”

You should ask yourself these two questions each morning and evening. In leading your team at work or teaching your students, be willing to help them reach for the gold inside of them.

Madeline Frank, Ph.D., DTM, John Maxwell Team Member, and Certified World Class Speaking Coach is an Amazon.com Best Selling Author, sought after speaker, business owner, teacher, researcher, and concert artist. She helps businesses and organizations “Tune Up their Businesses”. Her innovative observations show you the blue prints necessary to improve and keep your businesses successful. She writes a monthly newsletter “Madeline’s Monthly Article & Musical Tips Blog” and a monthly radio show “Madeline’s One Minute Musical Radio Show”. She has just published her new book “Leadership On A Shoestring Budget” available in print or as an e-book. To contact Madeline for your next speaking engagement: mfrankviola@gmail.com

Article Source: http://EzineArticles.com/expert/Madeline_Frank/466291

 

A Lesson in Neediness

I spent most of my weekend remodeling and redecorating but avoided bringing the heaviest package in from my car. A nice gentleman at Target loaded this package for me as it weighed
more than I thought I could carry.

I gazed at the package in my backseat when I arrived home tonight and thought I can do this. One time, two times, three times without any luck. If only a strong man, significant other
or even my dad were here, the package would be sitting on my living room floor waiting to be assembled.

As I took a deep breathe, the words popped out of my mouth…I need a man.

I felt a sense of disappointment for even thinking that let alone saying it out loud. After all, I am an independent woman, hear me roar.

Women everywhere are preaching independence. And as a 28 year old single, I have been preaching that too. But the heavy lifting got me thinking maybe it is okay to need a man or any relationship for that matter.

I recently heard a quote that says “A real relationship is when your desire for each other outweighs your need for each other.” So it is with all our relationships. We will face tough times where we “need” our friends, family, or significant other. And to reach out to them is not a sign of weakness.

The lesson is not to lose yourself to the relationship. Not to depend solely on the other person to get you through those times of “need.”

So I took that lesson and headed back to the car.I got that package in my living room. And when this nice young gentleman asked if he could help I batted my eyes and said, “Why yes will you please hold the door.”

Holly Powers (Holly@KevinEikenberry.com) is passionate about Customer Service in her role as the Client Development Princess for The Kevin Eikenberry Group (http://www.KevinEikenberry.com). She also the editor of Unleash Your Potential. Go to http://www.kevineikenberry.com/uypw/subscribe.asp to subscribe.

Article Source: http://EzineArticles.com/expert/Holly_Powers/606

 

What Are Your Working For?

Have you ever asked yourself this question? Are you working to have enough to pay the bills, with a little left over, maybe? To keep your head just above water? Many of us are.

Are you working just to get by, while enriching the already abundant lives of the few at the top? Nearly all of us are.

Do you think you deserve better, more, to be able to enjoy all of the fruits of capitalism, and not just the leftovers?

I do!

I want you to try something. Think a little bit about what you really want in life. Dream a little, if you will. Think big, not just enough to pay the bills and life relatively comfortably. How about enough to spend 20, 30, or 40 years in a comfortable retirement.

Far too many retirees are finding themselves having to go back to work just to get by. This seems to me like adding insult to injury. They already worked their whole life, played by the rules, and expected to get a little time off for good behavior in the end.

How about enough for a nice vacation home on the beach, or in the mountains? If you have kids, enough to pay for college without taking loans or completely bankrupting yourself might be a good start, if not as big as you could go.

Whether it be a dollar amount or an object such as the vacation home, be as specific as you can. Now, write down the amount in nice big print, or find a photo of the exact type of home, or whatever it is you want.

Post that piece of paper, tape it or tack it, in a place where you’ll see it every day, preferably several times a day. Over your desk, or on your computer monitor might be a good spot, or maybe on the fridge at home. Just put it in a spot where you look often during the day.

Now, ask your subconscious mind to figure out a way to get that which you desire. This is where most folks get lost. After you ask your subconscious mind, trust it to find the answer, and let it go to work. Just be patient, it will come back with the plan for you.

The subconscious is not only for memory storage, it’s also where all your new, untrained, ideas come from. When you have a problem and really have no idea of what to do, often you’ll find if you walk away for a moment, Bang!, the solution comes to you. It seems to come right out of thin air. This is your subconscious at work.

The picture or printed dollar amount will help your subconscious focus. It’s not enough alone, you have to ask your subconscious mind to help you. It doesn’t know what it is you want until you tell it. So you literally have to ask. Having something to focus on is, however, a great help.

Imagine, or envision yourself already having the thing you’re asking for. There is absolutely no reason why you can’t have it. The earth is very generous, if you’ve ever planted a garden you know this. You just have to help sometimes by planting the seeds, and giving a little water when it’s needed.

Now, this is the tricky part, if you ask and trust it to go to work for you, it will go to work for you. Your subconscious will come back with an answer, without fail. Then your conscious mind takes over. You have to follow through on what it tells you to do.

From here the three Ps go go work. Planning, Positive Attitude, and Persistence.

Try this visualization exercise, give it a couple of months. See what happens. It’s not as if you are taking any risks in giving it a shot.

Believe in yourself and your own abilities, it’s the first step in attaining anything worth having.

S. Minson

Prosperity-Net.com [http://www.prosperity-net.com/]

Get Your Slice Of the American Pie!

 

Designer Envy: Knock It Off!

CHANEL, VERSACE, DOLCE & GABBANA, VUITTON, GUCCI, DIOR, FENDI, PRADA, COACH, MARC JACOBS et al
.
As the holiday shopping season kicks into high gear, these are the brand-name clothing and fashion accessories that women will expect. But with the average cost of these items ranging from hundreds to thousands of dollars, how can the average woman afford these at all?

Add to the mix the celebrity endorsements. Paris Hilton wears CHANEL sunglasses, Jessica Simpson totes a VUITTON Speedy bag, Jennifer Lopez wears a DOLCE & GABBANA dress. “What’s Jennifer Aniston got on?” “Oooh what’s Madonna wearing?” Stars don’t have to worry about scrimping and saving to buy high-priced designer items; in most cases they don’t even have to pay anything, the companies freely give them the merchandise. Designers know that just having their products displayed by pop icons translates into millions of dollars in increased sales.

The celebrities are having a fashion party to which the average working woman is not invited.

So what is a woman of modest means to do?

Enter the knock-off. The fashion industry has created a need that the replica industry fulfills, designer clothing and accessories within the reach of the middle class budget.

By pricing their wares in the stratosphere, designers are essentially causing the knock-off market to thrive. Women see these must have fashion accessories in magazines like VOGUE and ELLE and want them. But when a handbag costs what the average middle class woman makes in a year, what choice does she have? She can’t afford the real thing so she buys a copy, much the same way that an art lover who desires a Picasso will hang a lithograph on his wall.

Each day on Canal Street in New York City, tour buses deliver scores of consumers who descend like vultures upon the rows of merchants who sell designer look-alikes. At the behest of the above mentioned designer corporations, the NYPD is constantly shutting down sellers and confiscating their merchandise, forcing these vendors underground as they try to keep up with the insatiable demand for replicas. Commenting on the public’s maniacal desire to own designer accessories, Tommy Y. a 20 something vendor sagely notes “We make them famous, and then they arrest us.”

The real irony comes when the fashion giant out sources the manufacture of their product to the very same company in China that is producing the copies. If the item is made by the same factory, how does one apply the “genuine” rule? Genuine as in “sanctioned by the manufacturer”?

A great deal of the blame must be placed squarely on the shoulders of the designers themselves. How can they justify such outrageous prices? VUITTON has a leather coin purse that sells for $275! MARC JACOBS has a $9,995 tote bag! HERMES’ bags start at $5,000 and rise steadily from there. CHANEL sunglasses average $300 per pair, non-prescription! Regardless of how loudly these companies cry foul, and hide behind trademark infringement laws, it’s all too obvious that they are greedily profiting from their media generated envy.

Gregory Lions is a former financial analyst for Dun & Bradstreet Inc. He is currently the CEO of BUYHEREBUYNOW.COM [http://buyherebuynow.com]

Article Source: http://EzineArticles.com/expert/Gregory_Lions/1270