ClaimVantage has built a range of cloud-based integrated claims processing solutions to solve the challenges employers, TPAs and insurance carriers face everyday. These solutions have the ability to be integrated to transform and improve the claim life cycle.

Both ClaimFirst and AbsenceDirect support a number of benefits and integrating these solutions can help capture vital claim information throughout the claim life cycle. For example, you could integrate disability and absence claims. Mary has previously taken job-protected FMLA leave for back pain she was experiencing intermittently. However, Mary may go out on disability the following year due to disabling back pain. Integration of Absence and Disability gives the claim manager a comprehensive overview of Mary’s claim history, making it easier to offer accommodations for Mary to return to work.

AbsenceDirect has the ability to be integrated with a number of different benefits supported by ClaimFirst, including:

  • Accident Only
  • Critical Illness
  • Disability (Both STD and LTD)
  • Long-Term Care (LTC)

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Integrated Disability and Absence Management Solution

The Integrated Disability & Absence Management Solution masterfully balances Disability, Absence Management, and more complex regulations, such as the FMLA, State, and ADA.

The integrated reflexive claim intake questions, answered either directly from the claimant or via a contact center, guides the administrator through the claim process. Having those answers linked to more than one set of rules around FMLA, Disability and State leave laws gives ClaimVantage the opportunity to evaluate layers of complicated and potentially conflicting requirements and data.

Integrating Disability and Absence claims processing into a single solution helps to prioritize independent, yet interrelated, information required for adjudication.

Key Benefits & Capabilities:

  • Provides a single point of intake for employees Disability and Absence claims.
  • Centralized database containing all disability and absence claim information, available in real-time for reporting and review.
  • The convenience of having one quick step to complete tasks.
  • 50% Reduction in operational costs and resources, through the integration of the intake process.
  • Generates automated eligibility and workflows based on specific FMLA, ADA and Disability leave laws.
  • Automated correspondence options, such as letters, email, and SMS to ensure all documentation is complete through the claim life cycle.
  • Automatically calculates time used, as well as time available – removing any manual effort for claims administrators.
  • Increased accuracy through the elimination of user error regarding claim eligibility.
  • Configurable custom settings make the system flexible and able to provide a familiar interface tailored to match your corporate brand.

Each element of the integrated claims processing solutions are also available separately.

Key Features

Mobile App

The Mobile app provides easy access to relevant claim information and documents, allowing the initiation of a claim from anywhere.

Mobile App

Reporting

Choose between preconfigured best practice report templates, or create your own reports using the easy drag and drop interface.

Reporting

Reflexive Claim Intake

Reflexive questioning ensures all necessary data is collected during the claim intake process, enhancing standardization and efficiency.

Reflexive Claim Intake

Benchmarking

Built-in benchmarking functionality make it easy for you to compare claim data against industry standards and focus on high-risk claims.

Benchmarking

Case Management

The ClaimVantage Case Management Journal allows you to effectively manage Action Plans, Eligibility, Medical Diagnosis, Communications, and Return to Work.

Case Management

Payments

Whether you want to consolidate payments, set up automated scheduling, or make a lump sum payment the ClaimVantage Solution meets your needs.

Payments

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