Available from Vikaran Solutions LLC
Provides insurance carriers, TPAs and Self-Insureds a very robust and complete claims management capability. FROI/FNOL drive automatic claim creation. Claims lifecycle transactions are maintained/viewed in an innovative, floating dashboard providing one click access to all claim detail including; compensability, awards, reserves, subrogation, litigation, bills, drug bills, payments, diary, notes, document management, claims transfer and excess. The module supports medical case management, nurse billing, third party bill and drug bill review. Automated reserving, diary and notes provide significant efficiencies.
ClaimsExpert represents a significant advance in technology allowing for advanced claims management, risk and loss management, third party medical bill reviews, drug bill reviews and service billing. A significant degree of automation is achieved with rule based payment processing and approval, bank account funding and automated rules based diary and notes. Reporting capabilities allow users to view loss runs at various levels within the customer’s organization.
ClaimsExpert uses several key capabilities of the Vikaran InsuranceExpert® platform including workflow engine, business rules engine, document management, customer portal, business partner portal and ad-hoc query tool. A modular design also supports most third party integrations. ClaimsExpert provides support for all IAIABC levels and EDI edits for 50 states.