Copyright © 2001 Business Insurance

Software Allows Employers to Audit Claims More Quickly November 5, 2001

by JOANNE WOJCIK


CORONADO, Calif.-By using their risk management information systems to audit the way third-party administrators are adjusting claims, employers can review more claims in less time, automation experts say.

Barbara A. Pelletreau, manager of the workers compensation program at the University of California in Oakland, says she can audit 90% of her claims ``with just the push of a button'' on her computer keyboard.

The software, designed by Alamo, Calif.-based Valley Oak Systems Inc., is programmed with benchmarks that are compared with actual claims, and any outliers are flagged and brought to the employer's attention, Ms. Pelletreau said. She made her comments after a session on vendor benchmarking at the Ninth Annual Business Insurance Workers Compensation and Disability Management Conference, held Oct. 22-24 in Coronado, Calif.

Mattel Inc. audits its claim files using a random selection process, reviewing about 10% of them annually, said Bernie Melchionne, senior corporate insurance administrator for the El Segundo, Calif.-based toymaker.

Also speaking during the session was Randy Wheeler, Valley Oak's president. Maria Bayne, president of Bayne Consulting Group Ltd., moderated the session.

© Copyright Business Insurance 2001