Fineos Launches US Claims System

FINEOS Extends Leadership in Workers' Compensation Processing  with New Claims System For US

Dublin based FINEOS Corporation, a global provider of insurance software, has launched a new product to manage claims for workers' compensation claims in the US at the annual National Workers' Compensation & Disability Conference in Chicago.

FINEOS CEO Michael Kelly welcomed the new product, saying: "Using FINEOS Claims will enable carriers' and state funds' efforts to offer a claims service that is consistent and transparent, ultimately creating mutually beneficial outcomes for employers, providers, workers' compensation writers, and injured workers."

He said  FINEOS Claims for Workers' Comp differentiates itself from more generic solutions because it has capabilities developed specifically for the US market, including preconfigured business content in areas such as compliance, fraud detection and medical management.  It can also integrate with industry-leading decision-support databases,  helping organisations to evaluate claims status against accepted rehabilitation timeframes.

"We believe that this is an underserved market that will benefit from the world-leading capabilities that FINEOS Claims can offer. US Workers' Compensation is also an industry with significant environmental issues including medical inflation, indemnity costs, and regulatory challenge," Kelly concluded.

FINEOS is already a proven solution in the workers' compensation arena with clients all over the world including the Accident Compensation Corporation (ACC) of New Zealand, WorkSafe Victoria (Australia) and the Saskatchewan Workers' Compensation Board (Canada). However, this new product has been developed to address the specific requirements of the US market, which is characterized by complex multi-state compliance and reporting requirements and it  builds on FINEOS' worldwide experience in handling injury and disability claims to help US carriers address these challenges.

Commenting on the new product,  insurance industry analyst Karlyn Carnahan, Principal at Novarica said:"Workers Compensation carriers know that the key to keeping costs low is implementing a relentless focus on disability management and medical cost containment to manage overall outcomes.

"FINEOS has leveraged its deep expertise in these areas to extend their claims management product to fully cater to US Workers Compensation carriers and we expect that it will deliver the kind of successful results they've proven in US Disability and in Workers Compensation in other parts of the world," Carnahan  concluded.

The new processing system  offers insurance carriers, TPA's, self-insureds, state funds, and other government entities a complete claims lifecycle management system that includes intake, payments, reserves, provider management, and other claims processes. It delivers rules and workflow capabilities that are flexible enough to easily accommodate changes to product definition, US regulatory requirements, and internal processing policies and also a powerful case structure, which is vital for managing workers' comp claims where multiple parties,such as nurse case managers, medical staff and  claims handlers are typically involved.

FINEOS solutions are built on a rules-driven, service-oriented, component-based enterprise platform that serves as a flexible infrastructure for new product introduction, legacy enrichment, and business transformation. FINEOS delivers documented benefits for some of the world's leading insurers, government agencies and banking institutions. The company is headquartered in Dublin, with offices in North America, Europe and Australasia.

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