How To Choose a Claims Management Software System

We were recently inspired by an article aptly named “How To Choose a Claims Management Software System” and thought we could make it easier for you to find the answers if they were all in one place. So here we go…

How long has the vendor been in business?

•  Established in April, 2000, Quick Internet Software Solutions is a dynamic and growing company. We have qualified, talented and service-oriented personnel interested not only in the success of our company but also the success of our clients. Our reputation is built on service and responsiveness to our clients. We consider ourselves a service company, who happens to sell software.
• Years of additions and improvements to this system has made ClaimPilot one of the most flexible and robust systems available. Our expertise with web-interfaced systems, web-security, accessibility and web navigation efficiency is unparalleled. ClaimPilot is designed from the perspective of the user, with intuitive system layout and screen progression. All is designed to make our system a natural extension of the work already being performed by claims professionals.

Is the vendor servicing other system users in your niche?

• Our clients include self-insured companies, government agencies, third party administrators, independent adjusting firms and more.
• They range in size from family-owned adjusting firms to Fortune 100 companies. ClaimPilot is used by over 81 organizations in 25 states and 62 cities. We have grown steadily since our founding and have a client retention rate of 99%. Our expertise provides the managerial experience and technical experience for the level of complexity required by today’s claim environment.
• ClaimPilot’s rapid and thorough response to client requests is always a top priority. Should a client need special customization above and beyond normal maintenance, a contract for development can easily be executed to address these unique needs. Open communication is always the rule. As our client base has grown, our Claims Management System, ClaimPilot has become more full featured and robust.

Will your claims data system integrate with underwriting and allow access by other departments?

• All clients are given the authority to determine the level of access for each of the users on their system. Various adjusters can be given different levels of access to the system information. Supervisors can be given access to reports that other adjusters do not have. Each of our client’s customers can be given read-only access that can be modified in a number of ways. Each user can be given the ability to run some reports and not others. Each user’s access can be set to allow different capabilities.

Does the system feature all the data categories you need?

• That is a hard question to answer without knowing more about your specific needs,  but we do take client needs and suggestions into account with every new project. Need certain additional fields? We can customize that for you.
• Here are a few of the things we do offer: Diary, Notes, State EDI, Bill Review, Functionality, Service Tracking, Reserve Management, Compensation Schedules, Bank Account Management and Check Cutting, Recoveries/Subrogation, Document Storage, Claim Importing, Medical/Legal, Report Generation, Form Letters, and Dashboards

How easy is the data to review and manipulate?

• ClaimPilot has extensive reporting capabilities built in. Over 100 predefined reports exist in our system that can further be modified by the user by simply changing the parameters of the reports.
• For option-based reporting, modified reports can be generated based on the parameters chosen by the user. This allows users to customize reports simply and quickly in a variety of ways. Customized reports can then be labeled and saved in the user’s reports table. Bar and pie graphs can be created and added to reports. All reports can then be exported to Microsoft Word, Excel, or PDF files. These reports can then be e-mailed to our customers clients. If our customer chooses, a view-only id can be provided to their client, enabling them to run their own ad-hoc reports whenever needed. Custom reports can be built as necessary at customer’s request.
• The Analytics Dashboard can also be used to easily review data visually. Charts on the dashboard are custom and can be made to show the exact data you need.
• ClaimPilot’s Search screens make finding and manipulating data a breeze.

How effective is the vendor’s documentation and customer support?

• Quick Internet Software Solutions offers exceptional customer support by staying in constant contact with partners. Our extended help desk hours are 7:00am to 6:00pm, central time, 5 days a week. This provides 9:00am – 4:00pm support from coast to coast regardless of time zone. Users of our system also have access to an emergency number available for emergency help 24 hours a day, 365 days a year. In addition to our dedicated help desk staff, everyone in the QISS family takes support calls as demand requires. Nothing is considered superior to answering a support call.
• We have very knowledgeable and personalized customer support. Our Tech Support team recognizes customers by name and they are never too busy for your requests or questions.
• Knowledgeable staff is sent for on-site training to new clients. On-site training can also be requested at any time.
• We offer a wide array of training videos. This means that after the initial on-site training offered when you join us, you have access to material and resources to refresh yourself on the system or to use with new employees. It makes training new hires easy.

Is your software cloud-based and easily viewed on a browser?

• When our founder, Dr. Quick, started Quick Internet Software Solutions more than 16 years ago, he founded it on the premise that claims management could best be handled on web-based, real time systems immediately accessible to adjusters, managers, and other parties interested in claim information. His Claims Management System (ClaimPilot) was the first system based entirely on the Internet. This allows all parties, regardless of physical location, access to complete, accurate and real-time data.
• QISS is an innovative firm, established exclusively to apply the latest technologies to the successful design of web-based claims management systems for the insurance community. Our comprehensive, integrated approach provides reliable service for claims operations through user-friendly search, retrieval, and claims processing capabilities.

Will your vendors help you survive the data conversion process?

• CONVERSION
  • There is a huge difference between discarding your old system, and discarding your old data. Access to historical information, entered under those old systems, is critical. In an effort to make the transition from your existing system to the ClaimPilot as seamless as possible, we can convert all data from your existing systems into ClaimPilot. We have completed data conversion for a wide variety of systems. If multiple data sources exist, all can be converted for a specific start date, or different data sources can be phased in based on the wishes of the client.
  • Before any conversion can be written, we must understand your data in its existing format. After receiving a full set of your data, about a month before implementation, our programmers will inspect the data, be sure they understand how your data is organized, and write a conversion routine mapping the data to ClaimPilot. This test data is then moved into the new database on our servers. During the weeks before implementation, training is done on the test data, which is your actual data, helping make the training process more realistic. Last minute changes can be made if necessary, based on how your data has been assimilated into our system. User’s of the new system can then experiment during the training exercises without fear of contaminating the data. Following training and just before the go-live date, a new set of data is submitted to the system and the old test data is completely discarded. This insures perfect integrity between the data in your old system and new system.
• TRAINING
  • Let’s face it. Most of us are terrified of change. We spend a great deal of time learning to do our job well, and the last thing we want is to be forced to learn a new system. At QISS, we realize that many of the rank and file employees of our customer’s business, may not immediately realize the benefit of switching systems. We also realize that as an owner or director of your company, employee downtime must be minimized.
  • We take great care in structuring the training to maximize time and minimize stress associated with learning a new system. First, we write a conversion routine to input a set of your existing data into your new ClaimPilot database AHEAD of training. Employees can then be trained using data with which they are already familiar. When we identify a set of familiar claims, those claims are used for the training. This encourages detailed questions to be asked regarding information that they know should be associated with those claims.
  • Then, portions of the training will be divided based on the tasks that the individual users will be expected to perform. Naturally, there may not be a need for most adjusters to learn how to pay bills and approve checks to be cut. Whoever is designated the system administrator will be given the authority to select security settings for all of the users, requiring unique training. Training usually begins with the entire group for a general understanding of ClaimPilot, then is divided as the day goes on to address these user specific needs.
  • After all of this is done, there will still be questions. Users can contact trainers directly with further questions, and our support desk is staffed from 7:00am to 6:00pm central time, to answer questions for all of our clients.
• SUPPORT
  • Following training, ClaimPilot continues to provide the support necessary to keep the transition running smoothly. In addition to our normal support staff, the entire office is placed on alert to the new customers using our system. The programmers involved in the conversion itself will also continue to involve themselves with the support of the client in the first few days and weeks.

Can your Claims Management System provide expert litigation management support?

• Any medical or legal information related to the claim can be stored under the separate medical and legal tabs on the claims screen. Information pertaining to doctors, lawyers, judges, etc., can be entered and applied to multiple claims.

What will your system cost?

• Most software companies promote themselves as service companies. But at QISS, this is much more than just an obligatory promotional statement. Since ClaimPilot is sold solely on a subscription basis with minimal up-front costs, the only way we retain our clients is by continuing daily to provide exceptional service and support. Our financial model is such that our success depends largely on the success of our clients. As our clients’ businesses grow, more users are added and QISS grows as well. Our success at offering superior service is evidenced by our 99% customer retention rate.

How secure is your data?

• Physical Security – ClaimPilot has an extensive security system. Our production servers are hosted by Core NAP, www.corenap.com, in a state of the art facility. In addition to this secure hosting site in Austin, Texas, data from ClaimPilot is replicated every 15 minutes to remote servers in Bryan, Texas with similar security systems in place, also capable of running the system entirely for all our clients.
• Data Security – All users are given unique ids and passwords. No plain text version of any password exists. When necessary, a password may be reset, but never viewed. Each CMS client is given its own database. No possibility exists for one client to access another’s data. Data to and from the user is also encrypted using Comodo standard SSL encryption. HIPAA information privacy rules are observed at all times.
• Functional Security – All clients are given the authority to determine the level of access for each of the users on their system. Various adjusters can be given different levels of access to the system information. Supervisors can be given access to reports that other adjusters do not have. Each of our client’s customers can be given read-only access that can be modified in a number of ways. Each user can be given the ability to run some reports and not others. Each user’s access can be set to allow different capabilities.
• Audit information can be gained by looking at the transaction tables associated with any claim. Any time a change is made to a claim, a record of the time, date, and userid associated with change is recorded. Simply looking at the table, will quickly show what change was made, when, and by whom. No change is made without documentation.