June Voting - Process Improvement Forum - Denial Submissions
Name: 


  1. The below requests were recommended for Denial. You are required to vote on each entry based on a scale of 1 to 5 with 5 being the best or highly recommended for denial. Please include comments supporting the ranking.


  1. System Enhancement

    I'm not sure if the scripting can be altered but, if you are filing a first party only claim, Claim Capture will allow you to enter all pertinent information: EE info, Incident info, first party info, etc before asking: "Is this a first party only claim?" Then it will refer you to another phone number in red for the callers to contact so they can file the claim and you have to cancel the claim. This can be very frustrating and upsetting to all parties. I'm hoping that the question could be asked at the beginning of the call. Thank you.


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  1. Examiner Mentors

    I also think it would be great if there were 1 or 2 mentors within the EXs that a SCR can reach out to via email and ask questions or get more information regarding the client’s processes.
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  1. Emailing Forms

    If EXs are able to email forms out to EEs for their DS claim, why are the EEs not able to email back. I have had multiple EEs call to have forms emailed or Re-Emailed (if time sensitive) and Fax or mail is the only option. * Fax is not always reliable.
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  1. Claim Communication 

    When filing a new claim in claim capture (multiple clients) it asks "Would you like to receive all claim communication by email or postal mail?", many EE's think that they will automatically receive ALL communication that way and get upset that they are still receiving phone calls. I believe that just by adding the word "written" to the statement it would cut down on confusion. Also many times even if EE's choose the email option they are still not automatically receiving their IP's that way.
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  1. Avaya Lookup and Name Display

    When transferring a call to an EX or a Pilot line numbers are often switched around and some extensions are incorrect taking away from efficiency of the call, delating hold times of the customer and resulting in the SCR spending additional time locating someone in outlook, then transferring the extension to Avaya. It would be helpful if Avaya were pre-loaded with current names and extensions of EX's, Managers, SR's and Etc.
    For example: the SCR needs to reach out to the EX, they begin to type in the EX's name and the name populates along with their corresponding extension or vice versa, when the SCR types in the extension the name of the person will appear indicating the correct extension was selected. Avaya should also be updated as extensions change and EE's move or are promoted, providing more efficiency and less delay in calls.


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  1. Caller phone # in Avaya 

    Provide SCR ability to click/paste incoming caller # from Avaya to claim notes. SCR used to be able to click/paste incoming phone # into claim notes but lost this feature with Avaya upgrade. Having the click/paste feature was a timesaver plus it reduces chance of SCR typo error.


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  1. Verifying security for an authorized caller 

    Currrently if an approved caller (MDO, Family member) is authorized to speak on behalf of a claiments claim, the name of the person is in the alert box.

    However, when verifying security with MDO, we are asked to verify the claiments DOB. If the MDO is caring for the claiments family member they typically do not have the date of birth for the employee. Could the EX place the date of birth next to the person that is being cared for or in the alert box, that way the SCR can verify security based on the patients date of birth.

    Regarding authorization to speak with an authorized caller. The process we follow now indicates that the agent
    will then need to complete security verification by utilizing the same standard verification procedure as if the third party caller was the claimant/employee. Many third party callers do not know the employee ID number, Employee's last 4 of SS#. When the authorized caller sends in the letter advising that SCMS can speak with them, can we have them provide their SS# and DOB on the authorization letter and have it noted in the alert box. That way they would need to cofirm their own personal information. Other
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  1. Populating an Icon for diaries 

    To avoid CCI's regarding diaries to the EX's. Can there be a way once a SCR is finished notating claims, if an ICON could populate, reminding the SCR "if a diary is needed for EX". A good example would be from claim capture when filing a intermittent LV and at the very end of claim, there is a statement in red that tells SCR's "if intermittent please remember to file absence."


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  1. Dial now in Juris

    Minimize copy & paste errors and eliminate 15 seconds per SCR when placing an outbound call to the examiner. Make a “Dial Now” button in JURIS to automatically dial the EX for the claim. The number has to be manually transferred from the claims software to the call software. If JURIS automatically launched Avaya and dialed the number we would eliminate 15 seconds per call and minimize EX contact errors.
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  1. Copy/Paste Feature in ClaimCapture notes 

    Allow or activate copy/paste feature in ClaimCapture comments section. EE provides info during intake that needs to go in comments. SCR used to put this info in a word doc & copy to the comments section. SCR has to go to comments section each time EE provides info that belongs in comments. Allowing or activating copy/paste feature in ClaimCapture would eliminate the time it takes to go back & forth between screens to add comments. SCR would be able to provide faster customer service, keep EE on phone a shorter amount of time, reduce call/wrap time.
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