Client: Midwestern TPA Challenge: Streamline the capture and reporting of claims information to major insurance clients Solution: CSC’s RISKMASTER to provide a central, server-based system for claims management Results: Distributed large volume of loss reports over Web, processed 1,700 monthly reports automatically, reduced medical bills to specifications of each state, measured productivity and set objectives for each adjuster Want More Information? Learn more about RISKMASTER software or contact us by phone or e-mail. Download the full case study (PDF) below. Download the file

A leading Midwestern third-party administrator (TPA) works with many major U.S. insurance companies to reduce their risk and insurance premiums through cost-effective claims processing, loss control, management analysis and alternative risk structures. But to meet the demand for better and more timely risk management information from the TPA’s clients, the company needed to replace its aging mainframe claims and risk management system.

Applying User-Friendly Technology
Before becoming a RISKMASTER client in May 1999, this TPA received its claims data from a mainframe computer. Monitoring adjuster and claims activity with a mainframe didn’t get the job done. Client reports generated by the system were difficult to understand, and when the vendor ran custom reports, they were costly in terms of both time and money.

RISKMASTER addressed these issues by quickly capturing and reporting claims information in a user-friendly way while reducing the TPA’s cost of managing this information, according to the TPA’s risk manager.

“RISKMASTER corrected this while reversing the escalating costs of managing our claims information,” the risk manager said. “This improved our bottom line considerably. We also wanted to control our data so we could offer it via a user-friendly, automated system to our adjusters. Now they spend less time on monitoring tasks and more time on critical management issues.”

Hard-Working System
The company uses a number of RISKMASTER modules to get the job done on its MS SQL server: Workers’ Compensation, all lines of business, RISKMASTER Business Intelligence, Best Practices, Event Scheduler, Bill Review, Auto Diary, and Entity Level Security.

The RISKMASTER database manages about 60,000 claims and 800,000 transactions. RISKMASTER enables TPAs to provide 24x7 access to the system, allowing their customers to review claim files, adjuster notes, financials and other data. Reports are processed in about five hours at night and posted on the Internet automatically for viewing in the morning — compared to the 10 days it used to take with the old system.

The risk manager indicated they had to produce, mail and manage more than 30,000 pages of reports monthly prior to converting to RISKMASTER. Today, the total paper produced has been reduced to zero.

Responsive Client Support
When technical issues have arisen, the company turned to CSC's support services for solutions. This resource has been invaluable at times when the size and scope of the project presented a variety of challenges.

To further reduce the time its staff spends on maintaining the property and auto schedules of its clients, the TPA plans to post the information on the Internet so clients can review and update them. To further demonstrate its client-service focus, the TPA is also adding Internet-based claims reporting, an Internet newsletter and an online training program.

“The response from our clients has been extremely favorable,” according to the risk manager. “RISKMASTER has helped us stay ahead of the competition and has brought new clients to our doors. We are looking for new ways of using our technology to further add value for our clients and to increase our productivity and efficiency.”