Unique Product Features
Initial Claims Triage
FastTrack’s Disability Risk Management Tools (DRMT) help the insurer assess and score the risk of each LTD claim through the following process:
- For New Claims & Open Claim Recertifications – DRMT provides the ability to input basic claimant demographic data (through manual and/or data feeds) to FastTrack’s Claim Triage Tools (CTT) to identify claims with potential risk management opportunities.
- Once data is loaded into the CTT portal, DRMT will compare each claim’s unique demographics to historical results in real-time and then, based on pre-determined carrier business rules, a determination will be made regarding the claim’s appropriateness for a full risk management evaluation using FastTrack’s Occupational Matching Tools.
Occupational Matching Tools
FastTrack’s Physical Capabilities Form (PCF) provides a superior way of capturing the claimant’s physical Restrictions & Limitations (R&L) data by providing a checkbox driven analysis document to the medical provider to record and quantify the claimant’s current abilities and R&L details (e.g. ability to sit, stand, walk, drive, bend, lift, carry, handle, use a computer, etc. and notes relative to depression, anxiety, PTSD, etc.). The FastTrack PCF provides the insurer with a much more comprehensive survey of the claimant’s abilities and R&L data thereby facilitating a more objective claims analysis. The FastTrack PCF readily lends itself to digitization as part of an automated LTD claims process and furnishes your claims adjudication staff with:
- Customized state-specific & carrier-specific PCF forms which can be completed by the physician/medical provider via the Internet, fax, email or by mail
- Automatic follow-up requests for the physician/medical provider to complete the PCF
- Insurer access to completed PCF input
- Storage of patient data by user defined unique identifier (i.e. claim #, claimant name, etc.)
Automated Occupational Opportunity Matching
Upon uploading the FastTrack PCF into DRMT, the claimant’s detailed R&L’s are compared against FastTrack’s proprietary Intelligent Occupational Library (IOL), which takes the best attributes of the O*Net and DOT classification databases (e.g., old occupations eliminated, new occupations included with job analyses) augmented by our occupational filtering technology to determine which occupations, if any, the claimant can perform given their current R&L’s. The claimant’s abilities are then automatically matched against more than 13,000 potential occupations based on the insurer’s policy definition (e.g. own occ, any occ, training, education, experience, gainful wages, etc.).
Detailed Occupational Matching Report and Automated Risk Management Pathways:
FastTrack DRMT automatically highlights capabilities and deficits by detailed physical task and directs the claim to specific triage categories for the next step in the adjudication process. The triage categories are customizable to match the insurer’s existing processes. Some examples are:
- Pathway 1: Not Totally Disabled “Own Occ” – Validate Liability
- Pathway 2: Not Totally Disabled “Own Occ” (Delayed) – Duration Management
- Pathway 3: Totally Disabled “Own Occ”, Not Totally Disabled “Any Occ” – Return-to-Work or Settlement
- Pathway 4: Past Change in Definition (CID) Date with “Any Occ” Capabilities – Validate Liability
- Pathway 5: Permanently Totally Disabled (PTD) – Validate MMI, if so, Consider Settlement and/or SSDI
- Pathway 6: No Occupations Identified, Possibly Overly Restrictive R&L’s – Additional Medical Required/Recommended
DRMT has built in smart technology which will identify potentially overly restrictive and red flagged physical capabilities reporting by the Attending Physician during the claims occupational matching process.
Summary of Product Benefits By Function
For the Carrier’s Management:
- DRMT lowers financial and operational risks and promotes cost containment by providing an objective, accurate, consistent, repeatable and legally defensible claims adjudication process
- DRMT provides a significant boost in productivity by focusing the right Benefit Specialists on the right claims at the right time
- DRMT has a substantial impact upon Disabled Life Reserves (DLR)
For the Benefit Specialists:
- Benefit Specialists who are happier because they are handling claims that match their core competencies
- Best Practices LTD process that accurately determines the claimant’s occupational capacity based on R&L’s and policy definition (Own Occ, Any Occ, Training, Education, Experience, Gainful Wages, etc.)
- Automated daily agenda/task diaries that will facilitate more effective time management