Insurance

Property & Casualty | Healthcare | Disability and Worker's Comp | Life and Annuity | Third Party Administrators

Property & Casualty

P&C companies often operate under multiple company names reflecting multiple lines of business: HomeOwners; Auto (commercial and personal); and Property (commercial and personal). P&C insurance companies typically issue payments to claimants, insureds, vendors and agents/adjusters, and PayPilot helps keep all the payment information for these companies and payees in sync. By linking back to the general ledger, in addition to the various claims systems, all payment status information is available from its originating system. The Paperless Office Companies have been talking about the "paperless office" for years. With PayPilot, it becomes a reality. The software’s foundation is an integrated database of payment information which eliminates the need to retain paper file copies. At any time, users can quickly look up any payment in the system, access all the information, and print whatever they need. Because all payment details can be automatically uploaded back to originating systems, you won’t waste time looking for payment status. You’ll know at a glance whether a payment has cleared or is not paid. PayPilot can also be linked to an imaging system so your users can see copies of payments issued at any time. Manage the Flood The more payments you process (and the more manual the process), the more challenges you face. For one, reconciling your bank accounts becomes an incredibly time-consuming, tedious task, particularly when state escheatage requirements are factored in. PayPilot’s bank reconciliation feature automates most of what you do manually today, including producing specialized registers of cashed and uncashed checks and customized escheatage reports. High check volumes also increase the potential for fraud. Manage this threat with PayPilot’s Positive Pay security feature. You send secure payment files to your bank so that no funds are exchanged unless presented checks exactly match the data in the file. For more information, read our Positive Pay page in the Products section. Keep Your Agents Happy You know how important your agents are in the retention and growth of your book. Use PayPilot to build on your already strong agent relations. Instead of sending out multiple commission checks, consolidate them into one—or better yet, convert them to a single electronic payment. Receiving consolidated payments, your agents can spend more time acquiring new policies.

Healthcare

Consolidate payments and improve information flow Healthcare insurers are information-intensive businesses. For each customer transaction, there are numerous parties that need to be kept apprised of both the case and the payment status. When you consider the large number of payments an insurer processes, this flow and distribution of information can dictate the success of the operation. Specialized Remittance Advice In all of its products, Prelude offers remittance advice that can be completely customized to each client’s workflows. Specialized information like Explanation of Benefits (EOBs), Explanation of Payments (EOPs), and Explanation of Remittance (EORs) can be easily added and attached to every payment. If you need to send multiple copies of your remittance advice to healthcare providers, case managers, employers, insured parties—whomever, PayPilot can be set to print the required copies on single or multiple printers for streamlined distribution. Remittance information can also be sent electronically as an image of the remittance advice or as a file. Payment Consolidation Healthcare payments are generally produced on a per-claim basis, causing high check volumes and operational inefficiencies. Given that so many of these checks are sent to the same provider, significant cost savings can be achieved by combining multiple claim payments into a single check or electronic payment. PayPilot can consolidate payments to a single provider (based on rules you provide) while generating a detailed listing of all claim information on one EOB or remittance advice. You lose all the wasted time and effort, and keep all the critical data.

Disability and Worker's Comp

Streamlining the processing of recurring payments Electronic Payments When employees leave work because of a disability or an injury sustained on the job, they are often entitled to insurance payments. Generally, these are recurring payments and can continue for a long period of time. As such, they are ideal candidates for electronic funds transfer, providing better service to the claimant (especially when the injury makes getting to the bank an ordeal) and cost reductions to you over paper checks. For those claimants without a banking relationship, paper checks can always be printed and sent by US Mail. A convenient feature of PayPilot is its automatic splitting of payments into paper and EFT streams. Combining Payments Workers’ Compensation insurers routinely send individual checks to the same healthcare providers over and over again. PayPilot can help you reduce the manual effort of processing all those separate payments by combining multiple claim payments into a single check or EFT. And even though the payment is consolidated, the remittance advice breaks out the detailed information for each claim. PayPilot also can be set to print the wording required to fulfill individual state regulations on the back of checks. Some companies use checks with the printing already on it, while others require duplex printing capability. PayPilot can handle either scenario. Delivery of Remittance Advice Paper remittance advice, conforming to the legal requirements of the states in which you do business, can easily be printed from PayPilot and sent to the claimant and other stakeholders. Prelude can help you customize your advice so that it contains all the unique fields of data required in your daily operations.

Life and Annuity

In the normal course of their business affairs, life and annuity insurers issue a lot of repetitive payments, often over a long duration. The processing of these payments is an excellent candidate for automation—and electronic funds transfer. The recipients of these payments fall into two main categories: Policy holders - during the payout phase of an annuity, policy holders receive a stream of payments at regular intervals, usually monthly. Converting these payments to electronic fund transfers (EFTs) can significantly reduce your costs. Customer acceptance of EFTs is expanding rapidly in today’s electronic culture - and for good reason. The funds hit their accounts faster and don’t require a trip to the bank. PayPilot easily accommodates the migration from paper checks to electronic payments. Agents – Many life and annuity insurers acquire policies through their network of agents for which they make regular commission payments. PayPilot can enhance insurer-agent relationships by combining multiple commissions into a single electronic payment. In addition, detailed commission information (e.g., by agent, by policy) can be included in the customized remittance advice. PayPilot can also handle negative commissions or credits when policies get canceled. Of course, for those customers and agents without a banking relationship, PayPilot can print out paper checks. The software automatically segregates payments into paper and electronic groups. It also includes escheat processing for tracking uncashed checks.

Third Party Administrators

The one-stop answer for multiple TPA challenges By the very nature of their business, Third Party Administrators (TPAs) deal with a lot of different companies. And many of their clients have multiple sub-accounts, each with a distinct set of risk locations and business rules. Simplification Through Centralized Control Imagine the logistics of handling separate business rules, signature policies, positive pay, and bank reconciliation for all these different entities. The day-to-day management of all that disparate processing can quickly turn into a nightmare. The solution to all these problems is centralized control through PayPilot. Business rules, workflows, and bank information are entered once and then automatically followed by every PayPilot function. The easy-to-use interface also makes changes to any company’s rules or information simple and painless. It’s the ultimate application of mass customization. Distribution In some cases, TPAs print out checks and remittance advice and then forward the payments to the insurer for mailing and distribution. In this scenario, it becomes critical to sort the payments in a certain order for the insurer’s subsequent handling. Perhaps by insurer and then by state, to give just one example. PayPilot’s integrated database of payment information easily enables the printing and sorting of payments by whatever criteria the client desires. Remittance advice can be sent to the TPA client or directly to the payee whether the payment is made by check or processed electronically. Data Export Another strength of the PayPilot application is its ability to export payment data back to clients and carriers. Exported data can include extensive payment details (e.g., 1099 and escheat information, payment status, etc.). This process can be automated in the system so that your customers are made aware of any disbursement activity as soon as it occurs.

Turn mobile payments into a strategic advantage

PointPay was specifically designed for insurance companies looking for a competitive advantage in accelerating claim settlements, simplifying workflows, and dramatically improving their customer service. Many of these companies already issue checks in the field manually and they recognize the opportunity to streamline their process. Like all elegant technical solutions, PointPay removes whole steps in the conventional mobile payment process. The end result is greatly reduced transaction times - and increased accuracy and security. Streamlining the processing of recurring payments Electronic Payments When employees leave work because of a disability or an injury sustained on the job, they are often entitled to insurance payments. Generally, these are recurring payments and can continue for a long period of time. As such, they are ideal candidates for electronic funds transfer, providing better service to the claimant (especially when the injury makes getting to the bank an ordeal) and cost reductions to you over paper checks. For those claimants without a banking relationship, paper checks can always be printed and sent by US Mail. A convenient feature of PayPilot is its automatic splitting of payments into paper and EFT streams. Combining Payments Workers’ Compensation insurers routinely send individual checks to the same healthcare providers over and over again. PayPilot can help you reduce the manual effort of processing all those separate payments by combining multiple claim payments into a single check or EFT. And even though the payment is consolidated, the remittance advice breaks out the detailed information for each claim. PayPilot also can be set to print the wording required to fulfill individual state regulations on the back of checks. Some companies use checks with the printing already on it, while others require duplex printing capability. PayPilot can handle either scenario. Delivery of Remittance Advice Paper remittance advice, conforming to the legal requirements of the states in which you do business, can easily be printed from PayPilot and sent to the claimant and other stakeholders. Prelude can help you customize your advice so that it contains all the unique fields of data required in your daily operations.

How it Works

  1. The insured (or his/her representative) reports the loss which is entered in the carrier’s claims management system.
  2. The adjuster downloads this claim data directly into his estimating software.
  3. The adjuster travels to the insured’s location to inspect the loss. He uses his estimating software or book to evaluate the extent of the loss and to determine the final settlement amount.
  4. PointPay, running locally on the adjuster's laptop, automatically imports this loss and estimating data for payment processing. No need for any re-entry of pertinent information. For those companies without estimating systems, the estimates can be manually entered right in PointPay.
  5. The adjuster reviews the payment information in PointPay, then prints a check/draft for the insured, issues an electronic payment, or loads a stored value card.
  6. As soon as he reconnects to the network, PointPay automatically transmits the most recent payment activity back to the carrier’s host systems (PayPilot, claims, and others).

Real Benefits

Expect to see a marked improvement in your claim performance. Your adjusters, suddenly more productive, will be able to close out claims more quickly and handle a greater case load. Management will notice the reduction in errors and the availability of back office staff for other tasks. IT will appreciate the automated transfer of data from field adjusters to the home office. And, of course, your customers will appreciate the prompt payment and professional level of service.
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