Integrate your Claims

For operational excellence

Our Integrated Disability and Absence Management (IDAM) platform streamlines the life cycle of each claim end-to-end, increasing claim processing efficiency, and improving the user experience.

Introduce Effective

Employee assistance

IDAM provides an integrated approach to managing disability benefits and employee leaves of absence, allowing you to better manage each case end-to-end while achieving cost and administrative efficiencies.

Built by industry experts, this cloud-native solution is hosted on the Salesforce Lightning Platform. Digitally managing the evolution of a claim on one central platform ensures all data is tracked and reported on, providing you with valuable insights to make data-driven decisions. This integrated approach offers you a competitive opportunity to introduce effective employee assistance and return to work programs while improving employee satisfaction.

IDAM Software

Solutions

Our IDAM platform seamlessly integrates our claims and absence management software solutions, enabling you to effectively manage both benefits on one central platform.

Managing a workforce is challenging, with federal and state regulations further complicating the process. Rather than focusing on each leave and disability claim request separately, our IDAM software manages both in one end-to-end claim management solution. The software helps you to masterfully balance leaves of absence alongside short-term disability (STD) and long-term disability (LTD) claims while keeping you compliant with complex regulations, like FML and PFL.

Key Features

IDAM Solution

Single Point
of Intake

For an improved
customer experience

Gain More
Knowledge

Improve claim
insights

Reduce Operational
Effort

Increase efficiency
by 30%

One Central Platform

To manage individual, group,
and worksite benefits

No More Manual
Processes

Automate workflows
and tasks

Key Features

Of IDAM

 Automated Workflows and Tasks

  Reflexive Claim Intake

  Case Management

 Adjudication

 Benefit and Payment Calculation

Automated Workflows and Tasks

  • Ensure the right person is doing the right thing at the right time.
  • Increase efficiency and reduce operational effort.
  • Increase accuracy and reduce human error.

Reflexive Claim Intake

  • Multiple claim creation ensures the right information is captured at intake.
  • Automated eligibility determination increases efficiency.
  • An integrated view of both absence and disability improves productivity and accuracy.

Case Management

  • See an overview of claim information in one location for increased efficiency.
  • View a consolidated list of all case notes.
  • Customize views by role, to manage what different users have access to.
  • Export all, or a portion of, case management data as a PDF.

Adjudication

  • Disability claim approval automatically triggers approval of applicable leaves, for increased efficiency and productivity.
  • Information and claim status is shared between absence and disability claims, for increased efficiency.

Benefit and Payment Calculation

  • Automate offset calculations such as return to work (RTW) based on information pulled from an existing system or manually entered into the IDAM system.
  • Increase the quality of calculations for benefits, payments, payment corrections, payment scheduling, and expense payments.
  • Boost efficiency and productivity.

The Right Vantage Point

For your business

Increase Operational Efficiency

By 30%

Replacing your legacy system with our cloud-native, multi-tenant solution can increase operational efficiency by 30%, by:

  • Replacing paper with digital files.
  • Reducing the number of systems you must access to process a claim.
  • Replacing manual steps with automated workflows and tasks.

Improved Customer Experience (CX)

With accurate and timely decisions

The IDAM platform is claimant-centric to ensure you deliver a superior customer experience. Your policyholders and claimants can access real-time information, at their own convenience, using a mobile device, tablet, or computer, with our self-service portal.

Verified by extensive user testing, the portal enables leave and claim requests to be easily created. Additionally, all information can be accessed in real-time, and necessary forms and documents can be downloaded and uploaded directly to the portal.

Life Cycle

Of an IDAM claim

Intake

The claim intake ‘wizard’ guides the user with reflexive questioning to ensure the necessary information is collected to create a claim, enhancing standardization and efficiency. This process can be configured to meet your specific business needs.

Once created, a claim can be manually or automatically assigned to a user or team based on predefined criteria, such as geographical location, or team structure.

ClaimVantage Wizard

Automated Eligibility
Determination

An employee’s eligibility will be determined when an absence claim is created. The system will check hours worked, length of service, and the employee’s work site to provide you with an eligibility determination for federal and state FML, PFL, and PFML regulations, as well as any other leaves configured on the system.

Workflows and
Communication

Although best-in-class workflows are set up as standard on the IDAM platform, we understand that each customer has a unique set of steps for processing claims. Our self-service workflows allow your system administrators to edit the standard configurable workflow sets, or to add new ones, specific to your business needs. Workflows can be triggered when:

  1. A claim detail changes
  2. A claim is created
  3. On a calendar date before or after a specific event

These workflow sets can be used to:

  1. Create tasks to help your team manage their work
  2. Create and send timely emails, letters, and SMS messages
  3. Automate your business processes through auto-adjudication

Leave & Case Management

Automated workflows and tasks ensure all steps in the process are complete to meet regulatory requirements. A task list is generated to ensure the right person is doing the right thing at the right time.

The platform also provides a case management journal, where your claim professionals can:

  • View benefit claimed details
  • Initiate an approval process when the benefit claimed status changes
  • Write a detailed synopsis
  • Document an action plan and next steps
  • Review and re-run eligibility rules
  • Attach forms and documents
  • Add and review notes in various categories
  • Document and view information in many sub-categories
  • View claim status and metrics

Auto-Adjudication

Introduce auto-adjudication to the claims process based on specific rules, minimizing the need for manual tasks. These rules can be configured to process claims based on the benefit type, eligibility status, and the payment specification, among other fields. Assignment rules can also be introduced with due dates to keep the claim duration on track. All adjudication rules and workflows can be configured depending on the level of automation you would like to introduce.

Regulatory Compliance
& Payments

No more manual checks on federal and state leave regulations. Our team of experts keep the system up-to-date, ensuring you are compliant with FML, PFL, and PFML regulations. PDF exports of all absence claims, including a complete history, in an easy-to-read format, are available for any DOL audit.

Our solution calculates disability payments based on the claim, policy, and benefit information provided. Whether you want to consolidate, set up automated scheduling, or make a lump sum payment, our software can be configured to meet your needs. Depending on your business process, the payment calculation options can be configured to allow claim-level or beneficiary-level payments.

AmeriHealth
partnered with ClaimVantage

ClaimVantage provided AmeriHealth with an integrated solution to efficiently manage disability and absence claims.

Claim Management

Software

Absence Management

Software

Accommodation Management

Software

IDAM

Software

Learn More About Our IDAM Platform

We would love to show you the unique features of our IDAM platform so you can see how quickly and efficiently integrated claims can be managed.

Take A Look At Our Case Studies

We’ve helped insurance carriers and, TPAs to perform digital transformation projects; from removing paper from the claims process, integrating multiple systems to improve the flow of information, and introducing auto-adjudication to improve operational efficiency.

ClaimVantage Shares Research Findings on COVID-19’s Impact on the Workplace

Portland, ME, November 19, 2020 – ClaimVantage, an international provider of claims and absence management solutions for the life and health industry, today released a report on COVID-19’s Impact on […]