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Articles

Property and Casualty Alignment with HIPAA

Guest Post by Tina Greene, Senior Regulatory Affairs Consultant

There are major healthcare regulatory mandates going in effect, at the federal and the state level, which will significantly impact property and casualty (P&C) insurance medical bills payers. The Administrative Simplification provisions of the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II), state mandates for property and casualty eBilling and more regulatory initiatives are forcing payers to understand these regulation’s requirements and be prepared to implement new processes and technologies in order to be compliant.

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Posted in: Articles, Auto Casualty Claims Processing

How Valuable is Your Reputation?

By Bryan Doyle, Product Manager, Customer Experience, Mitchell Auto Physical Damage

Unless you are running the only shop in town, you likely face some form of competition for customers. But just how valuable are loyal customers and how does a business in a competitive market inspire loyalty? These are questions facing every manager in just about every industry. While the importance of customer loyalty is obvious in industries such as soft drinks, coffee or even cellphones, the benefits of customer loyalty in the auto-repair industry may be less apparent, but it is just as important.

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Posted in: Articles, Collision Repair Management

Benefits of ICD-10 in Casualty Claims

Guest Post by Michele Hibbert-Iacobacci, Vice President, Mitchell International

The casualty claim arena involves evaluating and payment of claims for claimants who have suffered from an auto accident or workers’ compensation injury. This side of the health payment continuum has been omitted from the Health Insurance Portability and Accountability Act (HIPAA) as a covered entity.

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Posted in: Articles, Auto Casualty Claims Processing

How to Seamlessly Integrate ICD-10

Guest post by Michele Hibbert-Iacobacci, Vice President of Information Management & Client Services

Seamlessly integrate ICD-10? How is that possible? Realistically, yes, ICD-10 is new and the United States will start to utilize the new code set effective October 1, 2014.

Is ICD-10 really new, though? Not really, and frankly many entities are so ready they are looking forward to ICD-11, which has a “who knows when” implementation timeframe.

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Posted in: Articles, Auto Casualty Claims Processing

A Day in the Life of a Claim: The Review and Processing Phase

Part II: Best Practices and Liability Determinations
By Vidya Dinamani, Vice President of Product Management & Marketing,
Auto Casualty Solutions, Mitchell
Paul Rosenstein
Vice President, Claims Solutions, Mitchell

Once a claim has gone through the initial FNOL process, it moves on to the review and processing phase. Typically, the desk reviewer (DR) examines the damage repair estimate to ensure it is compliant with all of the business rules in place. If the DR finds any discrepancies or if the carrier is required to do so on direct repair shops, then a re-inspection may be ordered. This can set in motion several additional processes involving more people and more reports, for example:

  • A claims manager may need to report the results of the re-inspection to various state agencies.
  • Results may also be used to confirm compliance and to ensure that the body shop has adhered to the carrier’s direct repair program guidelines, as well as repair industry standards.

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Posted in: Articles, Auto Casualty Claims Processing

In the last of our three-part series, we review the settlement process and its impact on customer satisfaction rating and overall claims management efficiency.

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Posted in: Articles, Collision Repair Management

Medical Bill Review and Claims: The Devil is in the Details

By Christopher Tidball, Senior Director,
Casualty Solutions Consultant, Mitchell

Having been on the front lines of claims vendor management for a number of years, I will be the first to attest that things are not always what they seem. As much as insurers would like to commoditize many aspects of the claims procurement process, the reality is that vendor selection is far from simplistic.

From subrogation and salvage to legal counsel and private investigators, there is often a temptation to shoot for the lowest price. But is the lowest price really the lowest price? Rather than focus on price, the focus should be on the ultimate net cost. Perhaps nowhere is this more evident than on the medical bill review front.

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Posted in: Articles, Auto Casualty Claims Processing

Auto Parts Performance: Numbers Don’t Lie, But They Can Mislead

Measuring auto physical damage estimating performance by benchmarking key performance indicators (KPI) has been in place since the advent of electronic estimating. Unfortunately, so too have misunderstood metrics and efforts by appraisers to ‘game’ the numbers. This seems especially true when it comes to measuring auto parts performance.

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Posted in: Articles, Collision Repair Management

Lean Agile: The Customer-Centric Approach to Software Development

By Mike Bishop, Vice President, Product Development, Auto Casualty Solutions, Mitchell
Robin Peters, Manager, Business Systems Analysis, Auto Casualty Solutions, Mitchell

Technology companies using Agile development offer a variety of benefits for their customers, and ensure that the voice of the customer is truly integrated into all aspects of the software-development process.

Lean Agile is a software-development methodology that emphasizes incremental and iterative development, and is a departure from the more traditional waterfall style where work is planned and performed in a sequential manner (requirements, design, implementation, verification, maintenance). Where waterfall lends itself to so called “big-bang” releases, Lean Agile favors a more rapid and flexible approach where small amounts of functionality are delivered at more frequent intervals. This allows product organizations that employ Lean Agile concepts to be more responsive to customer requirements and needs as they evolve.

Lean Agile runs on a two-week cycle (termed a sprint), with the first few days devoted to planning and prioritizing what is next for development. Once the planning is completed for a specific sprint, the work is divided up among teams so the development is done in a simultaneous manner (as opposed to the sequential development in waterfall). The spirit of collaboration is essential to Lean Agile, since programmers and developers form self-directed teams to accomplish the many tasks necessary to create software.

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Posted in: Articles, Auto Casualty Claims Processing

A New Twist on Claims Outsourcing

Outsourcing has been a part of the insurance industry for about a decade. When people in claims hear the word it conjures up images of overseas call centers and image scanning.

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Posted in: Articles, Collision Repair Management

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