Insurance Claims Analysis and Straight Through Processing
ACORD has increased usage of straight through processing systems
A growing number of insurance providers have implemented ACORD, which has made it possible to implement automated straight through processing systems and improve claims analysis.
Figure 1. By using Skytide to analyze all straight-through processing claims and requests, insurance companies can update their system rules and see the results in only a few days, quickly decreasing the need for manual intervention by Underwriting without lowering quality standards.
This has resulted in significantly faster approval for claims and new policy requests without the intervention of Underwriting. Insurance companies are now focused on continually increasing the number of requests that are automatically approved by minimizing requests that are unnecessarily flagged as exceptions, without lowering their quality standards.
Remaining barriers slow performance improvements
There are two fundamental barriers to significant improvement in the performance of straight through processing systems.
- The marketplace is continually changing. For example: new medical information emerges that changes risk profiles or a new law takes effect that changes what can be offered in a particular region. This requires constant adjustments to the straight through processing scoring engine.
- The constant change leads to the second key challenge — completing analysis of current performance can take weeks to months, limiting the frequency with which companies can implement changes and evaluate the results.
Speed your improvement by speeding your analysis
The Skytide Analytical Platform™ enables insurance companies to improve dramatically the performance of their straight through processing for claims and new policy requests. This decreases the demand on manual underwriting without lowering the company’s quality standards.
Skytide’s innovative, XML-based analysis capabilities can identify what drives exceptions that could have been handled automatically, and does so very quickly — in a matter of 1–2 days instead of the conventional 4–6 weeks — all without IT intervention.
Skytide provides a timely feedback loop that looks at all requests that have been accepted or rejected, plus all that have gone straight through processing or through the underwriting process as exceptions. The solution can then identify “false negatives,” the specific questions or responses that appear to unnecessarily route requests to manual underwriting. Based on this insight, changes to the scoring engine can be implemented and results can be evaluated in a matter of days.
The results are timely response to market changes and faster improvement to the overall performance of the straight through processing system.
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