The Nebraska Department of Administrative Services successfully went live with new full featured Claims Management system developed by GL Solutions in June 2019. The new system allows Administrative Services to fully manage all tort, contract, miscellaneous and insurance claims filed against the State.
Offers full cycle claims management
Designed in full cooperation with key Agency staff, the new Claims Management system provides the Department of Administration with full cycle Claims Management: claim intake, claim event identification, claimant tracking, responsible agency assignment, claim investigation follow-up, risk manager review, and appropriate handling of claim resolution based on claim amount.
Includes claims management automation
Many administrative functions of the claim management process have been streamlined and automated. Previously, the administrative team would have to manually follow up on all claim investigations, receive results via email and manually process and upload those results to the correct claim. With its new system from GL Solutions, this process is fully automated. Automatic notifications are sent to follow up on claim investigation status. When claim investigation results are ready, the responsible agency directly accesses and uploads the results to the system rather than having to be handled via separate emails and manual uploads. In addition, the Risk Manager is automatically notified whenever a claim is ready for review. The Risk Manager can then quickly access, open and review claims and then process each one appropriately.
Reporting tools analyze claims data
The new Claims Management system includes a comprehensive suite of reporting tools to help Administration Services drill into its data and analyze trends. This includes Key Performance Indicators (KPIs) to help determine claim processing responsiveness and efficiency. It also includes the ability to identify trends and hotspots for types and locations of claims. Any field within the system is accessible via reports or queries at any time. The system includes pre-defined reports, queries and dashboards, and the ability for staff to perform ad hoc data queries themselves whenever needed.
In addition to direct claims management administration, GL Solutions has also included the following features to help improve and automate related functions for Administrative Services:
- Board Meeting Management – automated generation of claims board agendas and review materials.
- Insurance Policy Management – ensuring all state insurance policies are up to date and renewal notifications.
- Reporting Unsafe Conditions – including a mechanism for public and state employee reports of unsafe conditions to be tracked within the system, facilitating early identification and mitigation of risks.
- Workers Compensation Tracking – direct data feed into the Claims Management system to track workers compensation payments and costs.
- Claim Related Lawsuit Tracking – manage claims that have resulted in lawsuits.
- Automated Data Interfaces – developed interface with federal Medicaid Management and other third-party systems to facilitate automated data transfer and recovery of eligible costs.
- Reserve Fund Tracking – assign appropriate claim costs to reserve funds and track fund usage.
Adoption of its new system from GL Solutions has provided many improvements over its prior system. More efficient and automated claims processing, more detailed tracking of open claim stage data, better access to data from flexible queries, reports and dashboards, and implementing automated data interfaces are just a few of these improvements.