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Objectives . Identify the criteria of a strong program;Illustrate how to track/trend results;Translate results into information;Customizing the message to the audience;Continuing to monitor progress;Review of case studies.. Identifying the Criteria of a Strong Program . Disclosure/proactive com
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1. The Final Piece of the Puzzle: Demonstrating the Impact of the Successful Claims Management Program
Pamela L. Popp, MA JD DFASHRM CPHRM AIM
Robert Blasio JD
Western Litigation Inc.
2. Objectives Identify the criteria of a strong program;
Illustrate how to track/trend results;
Translate results into information;
Customizing the message to the audience;
Continuing to monitor progress;
Review of case studies.
3. Identifying the Criteria of a Strong Program Disclosure/proactive communication
Early resolution efforts
Early reserve recognition/placement
Engaged providers
4. Checklist of Criteria Staff Experience & Knowledge
Coverage Analysis & Application
Early Thorough Investigations
Sufficient Reserving
Proactive Resolutions
Vendor Management
Data Management
Loss Control
5. Impacting the Program Monitor the right things
Standardize what you can
Be proactive – identify closures, early resolutions
Reduce duplicative internal/external costs
6. 1. Monitor the Right Things Use a strong taxonomy
Track financial transaction detail
Look for trends not outliers
7. Did allegations/complaint include:
Elder abuse
Negligent infliction of emotional distress
Fraud
Clinical trial protocol issues
Product manufacture or distribution
Medication manufacture or distribution
8. Type of claim
Involved providers
Resolution dates/type
Whether disclosure done
Whether liability accepted/admitted
Whether disclosure presented at trial
Whether Emmi was utilized
9. 2. Standardize What You Can Consolidate strategy by case type
Assign counsel based on specialty
Preliminary medical review by same experts with fixed costs
Medical/legal research costs
10. 3. Be Proactive Immediate investigations
Immediate resolution consideration
Exposure mitigation efforts
Pre-litigation resolutions
Non-financial/creative resolutions
11. 4. Reduce Duplicative Costs Single record copy provider
Staff managing counsel
Overcharge percentages on invoices
Late charges on invoices
Expert retention fees
12. Tracking and Trending Results Provider participation/satisfaction levels
Decreased reporting time
Decreased external expenses
Increased reporting of events/near misses
Increased resolutions outside of litigation
13. Benchmarking What % judged to be result of error? What % payment in presence of error? and What % payment in absence of injury? What % ‘no payment’ in presence of error? What % payment in absence of error?