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Our Claims Management System, ClaimPilot is one of the most complete, robust systems on the market today. We handle all lines of insurance with confidence.


Diary

One of the best ways for users of the system to communicate with one another is through the use of the diary portion of our claims management system. Users are able to make diary entries for themselves or for other users of the system. Diary entries are always associated with the specific claim under consideration. Multiple diary entries per claim can exist as well as multiple entries per day. Diaries can be tagged with pre-defined purposes. Diary entries can also be set to appear in the future. When a claim is initiated, the user could enter a 2-week status check and a 1 month status check to appear when that time draws near, reminding the adjuster to follow up on a claim. Supervisors can enter this same type of future message for adjusters under his oversight. Anytime a user logs on to the system, the diary screen is the first screen they will see. Most of our clients use the diary feature as their primary way to communicate with each other concerning claims.

Notes

Notes are similar to diary entries in that they are also associated with a specific claim. However, note entries do not show up on a users home page. They generally contain more detailed information related to a claim. Diary and note entries are organized by date and viewed by claim and user. They both have the ability to interact with the Windows cut and paste feature. Our notes feature allows for the entry and storage of more detailed information associated with a claim.

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.

State EDI

As government departments and agencies adopt new technologies for making claims reporting easier, your claims management system should take advantage of these offerings. ClaimPilot provides the ability to comply with state EDI requirements right out of our system. State forms such as First Report of Injury and Supplemental Report of Injury are blue-printed in our system. Simply pull up the form and the claim information auto-fills into the fields. The form can be printed, saved, or submitted to the state via an EDI transmission.

Bill Review

ClaimPilot currently interfaces with most bill review and pharmacy card companies, and has the capability to add new bill review companies as necessary. Information is submitted daily so that adjusted bills can be imported into our system.

Functionality

Whether it's Worker's Compensation, with all of it's state reporting requirements, Property & Casualty, Auto Liability, or General Liability, Claims from all lines are managed by our system. When the claim type for a new claim is entered into ClaimPilot, the subsequent screens are customized to capture the necessary information unique to that claim type.

Service Tracking

Independent adjusters and Third Party administrators alike use our system to enter and track services performed for a specific claim. Rate sets can be defined on a client-specific basis, allowing for the automatic filling of the rate field. Our customers have the choice of defining as many types of services as they would like. All this allows for detailed itemization of services, including (but not limited to) adjuster hours, clerical time, mileage, photos, etc. Even customers who bill their clients at a flat rate often use this feature to track how much time is being spent on individual claims. All of this information is recorded and can then be used for invoicing the client as applicable.

Reserve Management

Reserves are tracked and adjusted through the system. Reserves can be set, increased, or decreased manually. Customers have the option of setting reserves to automatically increase as bills are submitted against the claim, or to be approved by an adjuster. Each transaction, whether a bill, reserve adjustment, or subrogation, is recorded and a log is produced that can be referenced to produce a snapshot of that claim at any given time and date. All reserve information can be reproduced in detailed loss runs by the user.

Compensation Schedules

Compensation schedules can be initiated out of the system to automatically produce compensation checks. ClaimPilot handles waiting periods, third party payments, and caps on total compensation paid.

Bank Account Management and Check Cutting

Checks can be cut directly out of ClaimPilot. Multiple payments to one entity can be rolled-up into one check, rather than cutting separate checks. Auto reconciliation of bank accounts is provided. We will load your company logo into our system so your checks can be cut on blank check stock.

Recoveries/Subrogation

Recoveries, subrogation, and salvages, are all itemized in our system under the reserve management section. Any recoveries made reduce the total incurred figure.

Document Storage

ClaimPilot allows you to upload any digital document associated with a claim. Our customers store pdf's, photos, Word documents, and audio files into our system. We have removed all total storage restrictions so our clients can store an unlimited number of documents. Our document storage system also features the popular drag and drop feature. Documents uploaded into the system are then set to lock after a default period of 24 hours (defined by customer) to prevent accidental destruction or deletion of data.

Claim Importing

ClaimPilot includes claim importing capabilities. The claim importer is essentially a web page that our customer's clients can go to in order to submit a prospective claim. After the prospective claim is submitted, the adjusting agency or TPA can inspect the proposed claim, add any additional information necessary, or reject the claim if it is determined to be an invalid claim. This feature streamlines the claim entry process and saves adjusting agencies time and money.

Medical/Legal

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.

Report Generation

ClaimPilot has extensive reporting capabilities built in. Over 100 pre-defined 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.

Form Letters

Form letters of all types are stored for our clients. When a particular form letter is referenced, all of the information related to the claim is auto-filled into the appropriate fields. The letters can then be printed and mailed, or saved as a pdf or word document and e-mailed.

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