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What is a claims handling pilot?

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A claims handling pilot delivers data-driven claims risk, fraud and wastage decisions directly into your claims process. Using real-world examples, learn how you can maximize straight through “Jet” processing while minimizing risk and fraud using a decision-centric, continuous improvement business architecture. Our proven decisions-first approach delivers the 5 elements of a powerful claims handling platform: decision model, business rules, risk and fraud analytics, impact analysis and continuous improvement.

Publicada em: Tecnologia
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What is a claims handling pilot?

  1. 1. @jamet123 #decisionmgt © 2018 Decision Management Solutions 1 What is a Claims Handling Pilot?  Demonstrate faster, more accurate claims handling  Engage all your stakeholders  Identify and prove the technology involved  Develop a plan for implementation
  2. 2. @jamet123 #decisionmgt © 2018 Decision Management Solutions James Taylor, CEO What is a Claims Handling Pilot?
  3. 3. @jamet123 #decisionmgt © 2018 Decision Management Solutions 3 Your Goals  Demonstrate faster, more accurate claims handling  Engage all your stakeholders  Identify and prove the technology involved  Develop a plan for implementation
  4. 4. @jamet123 #decisionmgt © 2018 Decision Management Solutions 4 This Webinar Will Help You  Build a shared vision at your company  See the steps that have helped others succeed
  5. 5. @jamet123 #decisionmgt © 2018 Decision Management Solutions 5 A Pilot Is Key To Next Best Action Success  Engages business stakeholders  Demonstrates value to technical stakeholders  Creates a believable future state  Proves transparency, agility and control upgrade  Readily extends to production - not a throw away
  6. 6. @jamet123 #decisionmgt © 2018 Decision Management Solutions 6 Develop a decision model Develop rules and analytics Deliver a working service Deliver decision-centric dashboard Claims Handling Pilot Plan
  7. 7. @jamet123 #decisionmgt © 2018 Decision Management Solutions 7 For a Successful Pilot Deliver These 5 Critical Elements Impact Analysis Business Rules Continuous Improvement Risk and Fraud Analytics Decision Model
  8. 8. @jamet123 #decisionmgt © 2018 Decision Management Solutions 8 Engage Business Stakeholders  Decision Modeling is  Rapid  Engaging  Enlightening  Open  And business stakeholders love it!
  9. 9. @jamet123 #decisionmgt © 2018 Decision Management Solutions 9 Demonstrate Technical Value  Persuade IT  Control  Integration  Persuade Analytics  Operationalization  Deployment options Analytical Models NeuralRules Business Rules
  10. 10. @jamet123 #decisionmgt © 2018 Decision Management Solutions 10 Show Future Operational Environment  From  One-Time Change  Deployment Risk  Lack of Control  To  Continuous Improvement  Incremental Change  Impact Analysis First
  11. 11. @jamet123 #decisionmgt © 2018 Decision Management Solutions 11 Prove Transparency, Agility, Control  Help The Business  See decisions made  Determine business impact  Propose rule changes  Test and validate changes  Simulate impact  Make Changes
  12. 12. @jamet123 #decisionmgt © 2018 Decision Management Solutions 12 Define A Path To Production  Reuse pilot components  Clear next steps  Complete the model  Integrate with production data  Test and learn  Agile, iterative development
  13. 13. @jamet123 #decisionmgt © 2018 Decision Management Solutions 13 The Destination: Consistent Agile Claims Handling External Data Big Data Business Rules Continuous Improvement Analytics and AI Chabot, Web or Claim Agents Consistent decision-making Enforce policies Apply predictive analytics Learn, Adapt, Improve
  14. 14. @jamet123 #decisionmgt © 2018 Decision Management Solutions 14 SUMMARY ▶ Benefits ▶ Engages business stakeholders ▶ Demonstrates value to technical stakeholders ▶ Creates a believable future state for the organization ▶ Proves transparency, agility and control can be improved ▶ Readily extends to production - not a throw away ▶ Schedule ▶ 10-12 week project Impact Analysis Business Rules Continuous Improvement Risk and Fraud Analytics Decision Model
  15. 15. @jamet123 #decisionmgt © 2018 Decision Management Solutions 15 Your Questions ▶ James Taylor, CEO ▶ james@decisionmanagementsolutions.com ▶ +1 650 400 3029 ▶ @jamet123 Enter questions for the Q&A here
  16. 16. @jamet123 #decisionmgt © 2018 Decision Management Solutions 16 Thank You  More resources for success with Claims  http://bit.ly/DMSClaims Decision Management Solutions works with clients to improve their business by applying business rules & analytic technology to automate & improve decisions. We can help you pilot a custom claims handling solution for your business.

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