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RISK & INSURANCE MAGAZINE

"Claims Management Systems: A Vital Comparison"

Directory: Leading Providers of Workers' Comp Claims Management Systems"

by Henry J. Padilla and David P. Duden

April 1999

Entire contents Copyright © 1999 RISK & INSURANCE


Company Name / Location AMI Risk Consultants Inc. / Miami
Key Industries Public sector
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational and non0ccupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported OSHA form generation
Interfaces Operational NA
Company Name / Location Blackburn Group Inc. / Rochester, NY
Key Industries Public sector, manufacturing, retail, insurance companies, third-party administrators, health care, and risk management, utility, property, and aviation.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day OSHA Form generation, and USL&H.
Interfaces Operational Index Bureau, SAP, Peoplesoft, BAAN, Lawson, Oracle Financials, and Legacy (All are customizable).
Company Name / Location Corporate Systems Inc. / Amarillo, Texas
Key Industries Public sector, manufacturing, retail, insurance companies, third-party administrators, and health care.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day OSHA Form generation, Federal Railway Administration / Federal Transportation, and USL&H.
Interfaces Operational Index Bureau
Company Name / Location DAVID Corp. / San Francisco
Key Industries Public sector, manufacturing, retail, third-party administrators, and health care.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day OSHA Form generation, Federal Railway Administration / Federal Transportation, and USL&H.
Interfaces Operational Index Bureau
Company Name / Location Delphi Technology Inc. / Cambridge, Mass.
Key Industries Public sector, manufacturing, retail, insurance companies, third-party administrators, and health care.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, and medical case management.
State Benefit Info State form generation, litigation management, and limited medical bill review/repricing
Regulatory Issues Supported EDI of state forms, and OSHA lost-day tracking.
Interfaces Operational Index Bureau
Company Name / Location DORN Technology Group Inc. / Livonia, Mich.
Key Industries Public sector, manufacturing, retail, insurance companies, third-party administrators, health care, risk management, utilities, gaming and transportation.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day OSHA Form generation, Federal Railway Administration / Federal Transportation, and USL&H.
Interfaces Operational Index Bureau (Nevada), Peoplesoft, Reliance, and Legion.
Company Name / Location Effisoft USA / Boston
Key Industries Public sector, manufacturing, retail, and insurance companies
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, and payment processing.
State Benefit Info Customizable to customers' needs.
Regulatory Issues Supported NA
Interfaces Operational NA
Company Name / Location Envision Technology Solutions LLC / Midvale, Utah
Key Industries Public sector, manufacturing, retail, insurance companies, third-party administrators, and health care.
Product Functions Supported Claims administration, policy management, litigation tracking, loss-reserve analysis, experience rate modification calculator, document linkage, payment processing, 200+ standard reports, diary and log functionality, workers' comp cost-containment advisor, query functions.
State Benefit Info First report and lititgation management
Regulatory Issues Supported OSHA lost-day tracking and OSHA form generation.
Interfaces Operational Customizable interface.
Company Name / Location GenSource Corp. / Cocoa Beach, Fla.
Key Industries Public sector, manufacturing, retail, insurance companies, third-party administrators, and health care.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day OSHA Form generation, and USL&H.
Interfaces Operational Index Bureau, SAP, Peoplesoft, and any OBDC compliant system.
Company Name / Location Medgate Inc. / Toronto, Ontario
Key Industries Public sector, manufacturing, retail, insurance companies, third-party administrators, health care, utilities, telecommunications, mining, and forestry.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, limited payment processing, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation
Regulatory Issues Supported EDI of state forms, OSHA lost-day tracking, and OSHA form generation.
Interfaces Operational NA
Company Name / Location MicroNiche Inc. / Eugene, Ore.
Key Industries Public sector, manufacturing, retail, and health care.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, occupational and nonoccupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day tracking, and OSHA form generation.
Interfaces Operational NA
Company Name / Location Mountain View Software Corp. / Layton, Utah
Key Industries Various
Product Functions Supported Claims management tracking, diary and adjuster notes, payment processing, occupational and nonoccupational disability management.
State Benefit Info State form generation
Regulatory Issues Supported EDI of state forms, OSHA lost-day tracking, and OSHA form generation.
Interfaces Operational Customizable interfacing
Company Name / Location Nichols / Jackson, Miss.
Key Industries Public sector, insurance companies, third-party administrators, and transportation.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, and payment processing.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day tracking, and OSHA form generation.
Interfaces Operational General Ledger Systems and Payroll Packages
Company Name / Location Policy Management Systems Corp. / Blythewood, S.C.
Key Industries Insurance companies
Product Functions Supported Claims management tracking, adjuster activity tracking, diary and adjuster notes, payment processing, injury management, occupational and nonoccupational disability management.
State Benefit Info State form generation (supported through third party)
Regulatory Issues Supported NA
Interfaces Operational NA
Company Name / Location Proformance Technologies / St. Louis
Key Industries Insurance companies and third-party administrators
Product Functions Supported Claims management tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation and litigation management
Regulatory Issues Supported OSHA lost-days tracking and OSHA form generation
Interfaces Operational NA
Company Name / Location Progressive Data Solutions / Orlando, Fla.
Key Industries Insurance companies and third-party administrators
Product Functions Supported Claims management tracking, adjuster activity tracking, diary and adjuster notes, payment processing, and medical case management.
State Benefit Info State form generation and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day tracking, OSHA form generation, and USL&H
Interfaces Operational NA
Company Name / Location Pyramid Services Inc. / Danbury, Conn.
Key Industries Retail, insurance companies, third-party administrators, and health care.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported EDI of state forms, OSHA lost-day tracking, and OSHA form generation
Interfaces Operational Index Bureau, Peoplesoft, and Oracle Financials
Company Name / Location Risk Sciences Group / Schaumburg, Ill.
Key Industries Public sector, manufacturing, retail, insurance companies, and third-party administrators.
Product Functions Supported Claims management/tracking, adjuster activity tracking, diary and adjuster notes, payment processing, and medical case management.
State Benefit Info State form generation, litigation management, and medical bill review/repricing
Regulatory Issues Supported OSHA lost-days tracking and OSHA form generation
Interfaces Operational Interfaces to any external systems
Company Name / Location RMS Systems Inc. / Denver
Key Industries Public sector, manufacturing, insurance companies, and health care.
Product Functions Supported Claims management tracking, diary and adjuster notes, medical case management, occupational and nonoccupational disability management.
State Benefit Info State form generation
Regulatory Issues Supported OSHA lost-days tracking and OSHA form generation
Interfaces Operational NA

Henry J. Padilla is RMIS/lab manager for Deloitte & Touche LLP in Hartford, Conn. David P. Duden is national RMIS practice leader for Deloitte & Touche.

Entire contents Copyright © 1998, RISK & INSURANCE. All rights reserved.