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FINEOS Extends Leadership in Workers' Compensation Claims With US Solution

FINEOS Extends Leadership in Workers' Compensation Claims With US Solution

New Claims Processing System to meet demanding requirements of US Market

FINEOS Corporation, the global provider of innovative enterprise software solutions for insurance, today announced the release of its new product to manage claims for workers’ compensation claims in the US. The new product was launched at the annual National Workers’ Compensation & Disability Conference in Chicago. 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. The product builds on FINEOS’ worldwide experience in handling injury and disability claims to help US carriers address these challenges.

Commenting on the release of the new product, 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.”

FINEOS Claims for Workers’ Comp offers insurance carriers, TPA’s, self-insureds, state funds, and other government entities complete claims lifecycle management including 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 are typically involved (nurse case managers, medical staff, claims handlers etc).

The product also differentiates itself from more generic solutions by including capabilities developed specifically for the US market including preconfigured business content in areas such as compliance, fraud detection and medical management. In addition, it can integrate with industry-leading decision-support databases to help organizations evaluate claims status against accepted rehabilitation timeframes.

Michael Kelly, CEO FINEOS Corporation, welcomed the launch of the new product. “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 challenges. 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.”