Injury & Claims Management System
Prev
Filter Case Studies
Challenges
Our client is a renowned health insurance company offering claim management solutions to multiple industries and enterprises. This platform is aimed to implement all business-critical activities of claims management and fraud detection. The client wanted to develop a continuously evolving application that will help insurance businesses to streamline injury management staff, provide best practice to their organization in a standardized, recurring and sustainable manner.
The client decided to develop an innovative and comprehensive system that would manage the records of injury-related claims, its processing details, and end to end visibility on claims cycle, its timeline, lower claims leakage, better fraud management and ultimately handle the overall business workflow. The business was challenged with multiple complexities such as manual hand-off resulting in higher processing time and increased spent on claim management.
To overcome these challenges, the client decided to develop a system that reduces paperwork, reduce the excessive use of excel spreadsheets and moreover save cost. Using this developed application, the business wants to effectively report and manage their workplace injuries, workers’ compensation claims, return to work processes (RTW) and payroll reimbursements.
The client has the following key objectives for developing an online system for claim management:
- To have a holistic view of all injured employees
- To capture, track and manage claims
- Allow multiple users from all the states of Australia
- Maintain centralized data repository
- Facilitate comprehensive reporting and analysis
- Develop an online management system that allows the user to access their injury-related data and facilities
- Design the system with pre-populated forms, automated alerts, automatic RTW plans and payroll reimbursement documents to save a lot of time and also reduce paperwork.
- Build a highly secured system guide - which assists users through the injury management process.
- Build a system with total transparency that provides complete visibility of all workplace injuries and worker compensation and claims.
- Develop a comprehensive reporting and analysis tool which enables users to filter, sort and instantly export the latest information in PDF, Excel or Word file format.
Expertise
Tools & Technology
- Angular
- Azure SQL Server
- MVC Web API
- Entity Framework Code first
- Email2DB
- Kendo UI
Solution
TatvaSoft has a proficient and expert team of developers with a thorough understanding of the latest software technologies and implements it to develop a flawless application. Depending on the needs of the businesses, TatvaSoft recommends the right technology that would benefit the client’s business in the longer run. Our skilled team developed a customized ERP solution using .NET technology that offers business advanced facilities such as Code access security and role-based security for faster and safe claim processing. Our solution covered the following modules:
Injury Management
- 128 Bit SSL protected login environment
- Managing all injured employees status and RTW (return to work) processes
- Support real-time capturing, tracking and managing claims information
- Pre-populated forms had the same look and feel like a paper copy for RTW
- Auto-calculate payroll or invoice or reimbursement of injury as per the setup policy
- Customized email template for a different kind of activity
- Facilitate multiple users support
- Claim-Management Timeline and activities
- Provides automated on-screen notification and email alerts
- Centralized data repository for all workplace injuries and claims
- Having comprehensive reporting and analyzing tools
Safety Management
- 128 Bit SSL protected login environment
- Portal for non-user to capture records
- Manage all type of incidents and hazards
- Manage Risks and Custom Register
- Instant notifications for any kind of activity
- A customized form design tool to design all types of forms with a wide variety of elements
- Support real-time capturing, tracking and managing incidence approval and action information
- Auditing facility for inspection of incidence and prepare audit reports
- Facilitate multiple user-support
- Provides automated on-screen and email alerts
- Comprehensive claim management reporting and analyzing tools
Health Management
- 128 Bit SSL protected login environment
- Centralized Employee records with all the necessary health information
- Preconfigured health framework and can configure any kind of form with dynamic form designing tool
- Health & Wellness Survey
- Schedule assessment reminder so never miss an event
- Instant notification for any kind of activity
- Support real-time capturing, tracking and managing all the health-related information
- Facilitate multiple users and support
- Provides automated on-screen and email alerts
- Comprehensive reporting and analyzing tools
Result
The Online Injury Management System has offered the client huge benefits to overcome their manual handoffs of the claim management system. It has greatly reduced the complexity of managing both the injured worker and claims under the Workers' Compensation legislation in Australia. The online system is a highly secure and comprehensive interface that provides a centralized database that offers real-time benefits from data-capturing, viewing, tracking, management and reporting of injured employees at the workplace, workers’ compensation and other claims benefits. Other benefits achieved were:
- Improved visibility of all injured employees, their details on claims
- Reduced time to Settle Claims
- Shorter claim lifecycle
- Faster generation of RTW (Return to Work) plans using a standardized process
- End-to-End Visibility
- End to End Management of Workplace Injuries