claims

We do a lot of work in insurance and we seem many companies spend heavily automating their claims process. Their intent is to improve their loss ratio – both by reducing losses due to fraud or bad claims and by reducing processing costs. But it often doesn’t make much difference because they are focused on [...]

Over the years, Decision Management Solutions has helped many leading insurance businesses modernize. We’ve helped them radically improve their claims handling, driving high rates of straight through processing with less fraud and less waste. We’ve helped them improve their top line sales numbers with automated cross-sell/up-sell, Next Best Offer or Next Best Action systems. We’ve worked with [...]

Last quarter Mark Breading of Strategy Meets Action wrote a couple of interesting pieces – COVID-19: A tipping point for insurance digital transformation? and Will COVID-19 Be The Tipping Point for Digital Transformation? I blogged about the general sense that digital transformation is being pushed by COVID-19 last week. But Mark makes a compelling case [...]

Digital Insurance’s Insurance Analytics and AI event is coming to New York, November 27-28 (new venue and date) Austin September 27-28, 2018. This is going to be a great place to learn how to use analytics, machine learning, data science and AI to modernize your insurance business. I’ll post more as the details firm up but [...]

I am giving a webinar on Boost Straight Through Processing in Your Claims System with Decision Automation at 10am Pacific on November 16. Register for this free webinar to see how you can automate decisions to handle more claims without manual intervention. Boost your Jet or Straight Through Processing rates to new heights to reduce costs, [...]

Last week we completed the main phase of a proof of concept project at a client, one based in Jakarta Indonesia. After the report out, I tweeted Loving watching a Dr at one of my clients explain (in Bahasa) the decision model for claims handling they built #dmn #decisionmgt Tweets are great for this kind [...]

Humana presented at InterConnect 2017 on their use of business rules on z/OS. Humana is a 3M member health insurer and a user of IBM Operational Decision Manager (ODM), IBM’s Business Rules Management System and has been focusing on using it to modernize some of their key mainframe systems – something that Humana is focusing on [...]

We have just posted a new white paper on Next Generation Claims Systems Decision Management delivers next generation claims systems that act immediately, increase agility, consistency and accuracy, improve customer satisfaction, speed response and reduce costs. Insurers can achieve significant speed-to-market gains, reduce fraud and create innovative new claims processes. Today’s insurance claims systems deliver [...]

I last got an update from Rapid Insight back in March of 2012. Since then they have made a number of updates to the products. To recap, Rapid Insight Veera is a data intelligence tool for creating analytical processes and modeling datasets (supporting an extract, transform, analyze metaphor) and Rapid Insight Analytics is a data [...]

I have been thinking about insurance claims processing a lot recently and working with a client to apply decision modeling to focus predictive analytics effectively in the claims process so this week’s white paper is Next Generation Claims Systems with Decision Management Decision Management delivers next generation claims systems that act immediately, increase agility, consistency and [...]

I am speaking at the Insurance Analytics Symposium this week so I thought I would post a link to a white paper relevant to the insurance industry – Next Generation Claims Systems with Decision Management. Decision Management delivers next generation claims systems that act immediately, increase agility, consistency and accuracy, improve customer satisfaction, speed response and [...]

A new week and a new white paper. This week’s it’s all about Next Generation Claims Systems with Decision Management: Decision Management delivers next generation claims systems that act immediately, increase agility, consistency and accuracy, improve customer satisfaction, speed response and reduce costs. Insurers can achieve significant speed-to-market gains, reduce fraud and create innovative new [...]

Just a quick note today on the power of Decision Management in customer service. I am on my health plan’s site, logged in and authenticated. I’m looking for some forms (because I have to fax a change in to them) but the site simply lists ALL the forms available. Why didn’t it DECIDE which forms [...]

Another solution session, this time Bob and Rick from IBM focused on IBM’s Signature Solution for Counter-Fraud, Waste and Abuse.  This is a classic Decision Management use case so I am looking forward to this one. Most fraud, they point out, is committed by insiders and goes undetected for 18 months. Frauds are also becoming a [...]

A new week and another new white paper. This week it is Next Generation Claims Systems with Decision Management Decision Management delivers next generation claims systems that act immediately, increase agility, consistency and accuracy, improve customer satisfaction, speed response and reduce costs. Insurers can achieve significant speed-to-market gains, reduce fraud and create innovative new claims [...]

I was struck over the weekend by this article on the BBC website – Call centre menu options catalogued by frustrated man. Essentially this guy has been documenting call center menus. As the article says “He started the project after growing frustrated about the number of options and amount of recorded information on call centre menus.” [...]

Day 2 at IBM IMPACT kicked off with another IBM keynote. Dave Farrell got it started telling us that IBM got record attendance this year and that customers will be talking about how “business in motion” has helped them. First up is Jim King of BMI – a licensing and rights management company in the [...]

Several years ago I did some work with Silverlink – speaking at a series of roadshows for their product – and I got an update recently. Silverlink focuses on helping healthcare organizations engage their members more effectively with personalized, multi-channel outreach. Silverlink works with health plans and pharmacy benefit managers to get their members to [...]

I have previously written about Angoss and its products (most recently this post on their 7.5 release) and recently got an update. As a company Angoss is focused on delivering data mining and predictive analytics to improve performance in sales, marketing and risk. They have a set of products for desktop, client/server and cloud-based and [...]