Manually reading claim notes is slow, arduous and inefficient

Our technology is fast and precise!

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Claim-Measure-Illustration2

ClaimMeasure ... A Solution for Claim and Risk Management Executives

New Management Tool

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ClaimMeasure represents a new tool that uses information identified and extracted from claim notes. New reports are created - including a composite score for every claim - which provide measurement of claims and adjusters' relative efficiency

Operational Metrics

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Identifying events and activities that happened, did not happen or may happen creates the ability to measure the performance on individual claims and of internal adjusters or TPAs handling the claims for an entire population rather than just a typical sample audit

Technology that Reads & Interprets

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Using technology to read and interpret sentence data creates enormous advantages for measuring the activities and events that are occurring in a population of claims

Increase Productivity

Claim Measure Increase productivity

The decisions people make about claims are documented in claim notes. Measuring the information written in the notes is a measurement of the knowledge people are applying to claims

ClaimMeasure Benefits:Faster ResultsNew KnowledgeConsistent Measurement

Faster Results are possible because in addition to reading claim notes faster than people, the aggregation of results is virtually automatic

New Knowledge is created by measuring the entire population of claims and creating a view of events and activities never before possible

Consistent Measurement of claim handling practices is possible because technology can routinely read every sentence in every note in every claim

ClaimMeasure Objectively Measures Events and Activities in Claim Notes

One Score - Many Details

Claim Score:7681657293100637787846759889673

Adjuster Score:8883647910073628571748293697510068

ClaimMeasure Key Features

Claim Measure Sara

The Power of SARA

The signature metric of ClaimMeasure is the ratio of Substantive Actions to Routine Activities (SARA)

A Substantive Action is a meaningful action documented in a claim note that moved the claim towards resolution. A claim note containing at least one meaningful action is considered to be a Substantive Action claim note

A claim note with no meaningful action is labeled as a Routine Activity note

Comparing claim handlers' SARA metrics provides dynamic insight into claim handler proficiency

Claim Measure Access without Implementation

Access without Implementation

ClaimMeasure operates in an independent environment and is fully complementary to all claim systems

Compare it to the way numbers are exported from systems and loaded into a spreadsheet for analysis. In the same way, sentences are exported, processed and loaded into ClaimMeasure

Results are available without systems implementation

ClaimMeasure - The Old vs The New

ClaimMeasure: A Paradigm Shift in Claim Audits

  • ClaimMeasure is a tool for objectively measuring claim activities and claim handler performance

  • SD Refinery technology reads and interprets every sentence written in ever claim note in every claim file

  • Operational metrics are created to score both handlers and claims against the norms for any given population of claims

Claim Audits - The Old Way

Claim audits have been around since 1347!
The conventional process

  • Select a sample of claim files
  • Multiple people (with varying levels of experience) read and review the claim files
  • Results from individual reviewers are aggregated through various means to form a conclusion
  • The overall results are presented to management
  • Management and reviewers argue about whether the sample was representative of the population

Technology - The New Way

Using SD Refinery’s technology for ClaimMeasure creates enormous advantages

  • Every sentence of every claim file is read
  • Every claim file is read consistently
  • The aggregate results for the population are created without bias
  • Issues, problems and opportunities are identified for the entire population of claims
  • Strengths and weakness of individual claim handlers are quickly identified

Which ClaimMeasure is Right for You?

  • Aviation

  • Commercial Auto

  • General Liability - Primary & Excess

  • Professional Liability

  • Self-insured Healthcare

  • Umbrella

  • Workers Comp

Ready for More? Click below to download an introduction to ClaimMeasure

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ClaimMeasure-Workers Comp is a jointly developed and owned product of SD Refinery and Milliman Inc.