HNC Decision Manager for Claims

HNC Software Inc., a New Orleans-based decision management software provider, has unveiled HNC Decision Manager for Claims, an automated claims management system for workers’ compensation carriers. Hindered by Sept. 11 claims and lower returns on investments, workers’ comp carriers are registering a 135 percent combined loss ratio (for every dollar they receive in premium, $1.35 is paid). However, industry analysts estimate that insurance companies could save billions of dollars each year by improving efficiencies in claims processing. HNC Decision Manager automatically raises issues concerning medical factors, return to work issues and risks, litigation merits, strategies, and costs when a claim is filed so adjusters can act on the most critical issues and risk factors. The system also can recommend a course of action in real-time, and continues bringing this recommendation to the attention of adjustersuntil the claims process is complete. The technology enables beginning adjusters to have the same body of knowledge and best practices available to them as their more experienced counterparts, resulting in a “best practices” approach throughout the organization. HNC’s medical bill review software for workers’ comp reviews more than 30 percent of the nation’s workers’ comp bills. HNC Decision Manager for Claims combines HNC’s technology with its experience in workers’ comp, incorporating best practices and extensive knowledge in predictive modeling
to enable the most efficient claims investi-gation process possible. With the software, cases are instantly re-analyzed and new actions recommended when information changes. In addition, the system also helps to reduce litigation through speedy and accurate responses, and manages permanent disability and lifetime medical treatment awards.

Topics Claims Workers' Compensation