Balance The Claims File - Part 1

Thursday, January 31, 2002 | 0

Balancing the claim file - seems like an onerous task, but once the skills are mastered, this "act" will not only improve your claims management statistics, but also improve results on your claims making the ultimate bosses, the employer and the injured worker, happier. In this article we will explore the reasons for balancing the file and why it should be done as a regular routine, not just on those files of which the task is requested.

Auditing what has been paid versus what should have been paid catches errors. This eliminates big problems down the road when someone decides to undertake that task for you - with our without your consent and knowledge.

Once you master the principles of claims file accounting your skills are transferable across job lines, improving your employability when the inevitable downturn in claims positions occurs. You will also decrease your stress and anxiety knowing that your claims files are in order and can withstand an audit.

Balancing claims files not only reduces error, and improves audit statistics, but penalty exposure is likewise reduced. When you have the edge in quality claims management, knowing that your benefit payments are accurate, you will be empowered in claims status meetings, and be able to assert with authority that your file is accurate, and up to date.

The next article will discuss some balancing principles and tips for ensuring accurately maintained balance sheets.



Author Cyndi Koppany is Vice President in charge of Training for Cambridge International. She can be reached at ckcyndi_koppany@cisgi.com.