Changing Claims Software: It’s Not as Hard as You Think

Three words can evoke fear and create pushbacks because of the big what ifs, the mysterious unknowns or a not-so-great been there/done that.

Those three words: claims software conversion. 

Fortunately, there’s good news. When managed properly by experienced professionals, your claims software conversion is a methodical, strategic process with safeguards in place to identify potential red flags before they become big headaches. More on that later.

If It Ain’t Broke

As the saying goes, if it ain’t broke, don’t fix it. But what we often find is that existing claims management software programs are indeed broken or speeding in that direction, which manifests in many forms.

g You can’t capture or report on the data you need.

g Your existing system is outdated or being phased out.

g Your existing software has been purchased by another company and the cost has increased.

g You’re becoming more aggressive with client acquisitions, and your existing system simply can’t scale with your growth.

g You went through a conversion that was managed poorly, and the new system doesn’t adequately address your needs.

If one or more of these scenarios hits home, a claims software conversion is likely in your future, and it doesn’t have to be a process riddled with fear.

The Conversion Process from 30,000 Feet

While the name of the game is in the details, this view from 30,000 feet provides a broad overview of what a streamlined ClaimPilot conversion process entails for a third-party administrator (TPA).

1.     Your claims management system provides ClaimPilot with sample data and loss runs.

2.     ClaimPilot imports your sample data and loss runs into a “sandbox” test environment on our system. We write a series of SQL import screens – a tedious process because each of the stacked tables must be populated in a specific sequence. Our experienced analysts go field by field and table by table to thoroughly build out the scripts, run them in sequence and verify the results against the original tables. We look at the totals for each of the coverages (e.g., Worker’s Compensation coverage has an indemnity bucket), compare that to the totals we ran on the imported data and match it to the penny with a tie off.

3.     Your point of contact accesses the ClaimPilot sandbox, reviews that data, determines if any data has been placed in the wrong table and communicates those changes to us. To assist you in the review process, ClaimPilot shares the conversion data statistics, which is particularly beneficial in pinpointing red flags. We also detail where the data was taken from and the specific table into which that data was placed.

4.     Together we participate in weekly calls to address conversion issues until everything is ironed out in the sample data and loss runs.

5.     After the data has been reviewed, tweaked and tied off, your claims management system provides ClaimPilot with the full data set, typically on a Friday evening.

6.     ClaimPilot seamlessly executes the conversion over the weekend.

7.     On Monday morning, we provide you with logins and total tie offs that match to the penny. Your conversion to ClaimPilot’s web-based claims management solution is now complete.

With any claims management software conversion comes training, and we’ll address ClaimPilot’s industry-leading training and client support in future blogs.

Types of Conversions

In addition to TPA conversions like the one referenced above, ClaimPilot also executes conversions for our TPA clients’ clients. For example, we might have a TPA client that wins a municipality’s claims management for Workers’ Compensation. In that instance, we work with the municipality’s claims management software system to convert the data and meet the live date stated in the contract.

There are also small TPAs, self-insured small businesses and municipalities that manage their data in-house. At some point, the database grows beyond control and can no longer be tracked in Excel software. There’s typically only one person who knows where all the data is, and while that person tries to pull it together, it’s typically a big mess of unorganized data.

As you can imagine, every conversion is unique, and there’s no one-size-fits-all cost for conversions that range from a clear-cut extreme – all the data is in a handful of well-defined spreadsheets – to an extremely scattered extreme – the data is unorganized and tangled. Whatever the scenario, ClaimPilot bends over backward to accommodate valued clients and build lasting relationships.

Our Attributes to Your Advantage

Handing over your claims data to a new claims management company is, at some level, terrifying.

Wave goodbye to your fears by putting ClaimPilot’s expertise to your advantage. We have:

√ 20 years of conversion experience

√ A firm grasp on the requirements, risks and challenges associated with conversions

√ An organized, thorough process

√ A team of local Texans who are experienced and eager to communicate and execute

√ Respect for your live date

√ Solid references

√ A spirit of transparency and collaboration

Regardless of whether your conversion is proactive or reactive, our bottom line aligns with your bottom line: a simple yet thorough conversion with perfection to the penny.

Where Are You Now?

Are you dissatisfied with your current claims management system? Are you being forced to leave your existing claims management company? Are you shopping for a better deal? Is your current claims management software dampening your growth?

Take the first step in making an claims management software decision by requesting a ClaimPilot demo here.

We look forward to introducing you to ClaimPilot’s customizable software that can unleash new opportunities to scale your business.