The connection between complete command of data and lowering all disability insurance claims and related legal costs is indisputable. Problem is, finding a technology platform that can deliver truly integrated data, regardless of source, historically has been elusive.
Whether it is occupational or nonoccupational disability, it makes sense to have the data easily available, within a single system. But the limited technology options, along with some very tough-to-change traditions, have worked together to realize that goal.
According to Jeff Ninowski, product manager for CSC's RISKMASTER, it really doesn't have to be that way.
Ninowski explains that for years, occupational and nonoccupational disability claim data has existed in separate "silos," as risk managers and their counterparts in human resources have not had a strong connection in making sure all disability-based employee absence is managed from a single point. That, in turn, has led to disparate technology platforms and systems for managing the data in workers' comp and nonoccupational disability claims. On paper it makes little sense because disability data is disability data, regardless of how the claim came to be.
"We hear from clients and from the insurance industry at large--everyone seems to agree - that an integrated disability component is necessary and needed," Ninowski says. "But it takes more than agreement to change the status quo. It also takes a strong effort in breaking down the silos between HR and risk management.
"We try to educate companies about how important this is, from both a total claim cost perspective and also in terms of getting employees back to work for their quality of life," he says.
To succeed at managing data from a more "holistic," one-source approach, CSC offers its RISKMASTER Integrated Disability Management (IDM) platform. And within RISKMASTER, CSC also offers its Legal Solutions Suite (LSS), to help manage legal bills, both in disability and now, for the first time, even in nondisability legal cost management.
Ninowski says that by combining CSC's core workers' comp module with the optional nonoccupational and case management modules, customers can effectively manage all employee disability claims. At the same time, this type of integrated solution will help organizations dismantle the barriers that exist between risk management and human resources.
On the comp side, RISKMASTER Workers' Compensation helps confront medical cost management issues, lost time cases, employee injuries and other safety issues. It offers complete claims processing, from notes to jurisdictional forms.
"We start by giving customers the best options to evaluate changes in workers' comp or safety trends by company, location, job, employee and other criteria, and to easily identify the types of accidents that generate the greatest amount of lost time or money," he says, adding that claims are handled from first report of injury through resolution.
But just as importantly, RISKMASTER IDM connects directly to employee records, providing a flexible database design that can maintain a comprehensive history by linking pertinent claim data to employee records.
On the non-comp side of the house, RISKMASTER's Non-Occupational Disability module includes short-term and long-term disability, as well as Family Medical Leave Act (FMLA)--an all-in-one system minimizes complex workflows and helps examiners more efficiently manage claims. Through its Case Management module, nurses, examiners and bill analysts can share real-time information related to the appropriateness of care. Users capture information pertinent to both losses and litigation.
Interface with Medical Disability Advisor (MDA) Guidelines, an optional component of Case Management that helps improve manage and measure health-related absences.
Most of all, RISKMASTER IDM can integrate data from both disability areas--bridging the historical gap that leads to higher disability costs and longer return-to-work timelines for employees.
One tool for integrated data management, for example, is RISKMASTER Business Analytics, which combines powerful user-friendly ad-hoc reporting along with dashboards to easily combine both worker's comp and nonoccupational disability data into meaningful reports. With all of the data in a single system, reporting is seamless and provides customers with access to all employee data.
"The key thing is combining a powerful workers' comp component with the ability to manage nonoccupational disability claims within the same system," Ninowski says. "As far as we can tell, CSC is the only provider offering an integrated data approach to all disability claims. It's only logical that accessing and managing that data from a single system will reduce costs."
On the legal front, Chris Charlton, Solution Marketing and Strategy Manager, says the same silos often exist between risk management, HR and legal. So the identical challenge--integrating data and information--exists.
To break down those barriers and as part of the overall effort to reduce the cost of claims, CSC offers its Legal Solutions Suite (LSS). Even more, and a relatively new development, LSS can be used by any company across any market that has outside legal expenses. It is a claims product, but can do more wherever legal services are used, Charlton explains.
"Integration is the critical success factor, and we really believe we are the integration kings when it comes to legal bills, data, etc.," Charlton says. "We can integrate LSS with any front end or back end system. It's a true end-to-end legal data solution."
In the meantime, LSS offers corporate legal teams and claims departments a chance do more with less ? their biggest challenge today (and their biggest pain point).
"Legal costs and caseloads on the rise," he says.
CSC's LSS software can simplify the billing process, analyze legal expenses, document law firm performance and create a collaborative electronic workspace for budgeting, planning and strategy. Its three major components--Legal e-Bill, Legal Bill Analyzer and Legal Matter Manager--work together as a suite of products, or they can be used individually to integrate with existing case, claims and accounting systems.
Charlton explains that the software helps ensure that a customer only pays what they owe based on fee guidelines. But, in addition, it also helps accelerate the bill review and approval process, which also reduces cost and speeds up claim resolution.
According to Charlton, more than 7,000 law firms are submitting invoices with CSC's Legal e-Bill component, which provides a secure, Internet-based portal for submitting legal bills. The software features a rules engine that is easily customized to your organization's billing guidelines and business practices.
For example, the software can tell a client when senior attorneys are charging you for tasks that should have been performed by paralegals, or if law firms are overbilling for the time they spend in status conferences. It also offers features such as third-party expense entry, enhanced workflow, and adjuster dashboard, and usability enhancements developed by legal professionals and supported by CSC, one of the world's leading information technology firms.
And, of course, there is total integration with CSC's RISKMASTER IDM--a critical tool in the effort to take down the silos that can help reduce the overall cost of claims.
"The back and forth communication between the two products increases productivity while allowing for industry best practices," Charlton says.
As CSC's Ninowski notes, change does not come easily. When the HR group and risk management group are not communicating, higher claim costs will result. But getting those two parties, along with legal, on the same page can happen, as there are tools out there that allow them to do just that.
"Sometimes, people are ready to break down the walls, but they find two different, unconnected systems, so they are stymied even with the best of intentions," he says. "They will say it makes sense, but feel overwhelmed and need a partner that can help them get it done."
In some cases, he adds, they first need to redesign their current disability claims process, rather than try to stuff their current, silo-based business model into any new technology.
Ninowski explains that if cost or reluctance to change are hurdles, the best thing is that a company doesn't "have to jump into the pool" all at once. They can start with the basics, add as they go along, and eventually, they can take advantage of a single data management process, for all disability claims.
"Right now, HR and risk management are not talking in many organizations," he says. "The old perception, and a prescription for higher disability claim costs, is that that HR deals with employee-related information, not workers' comp claims. But an employee is an employee, and when they are out of work, it is still a cost to the company."
For more information on either CSC's RISKMASTER or Legal Solutions Suite, call 800-345-7672 or email email@example.com.
piece is part of our continuing Insights series designed to highlight key products and services to our readers. This paid-for
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October 28, 2009
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