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Tracking Insurance Fraud Investigations Using Case Management Software
The Coalition Against Insurance Fraud estimates that insurance fraud is responsible for more than $80 billion in losses annually. With losses like these, there is no time to waste when you are investigating insurance fraud cases.
Insurance fraud investigations can be complex and time-consuming. Fortunately, using case management software can make the process a whole lot easier. You can catch fraudsters faster, work more efficiently, and ensure your reports are error-free.
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Benefits of Case Management Software
Relying on paper filing systems or worse, employees' memories, is both ineffective and inefficient. Case management software includes features that save hours of work while also helping you conduct more accurate insurance fraud investigations.
Form Templates
Completing forms is tedious and time-consuming. The right case management software solution can include templates for SARs and other essential forms to make the process faster and easier. Your organization will save time and eliminate duplication of effort.
Templates reduce your chances of missing data or making errors in your reports, ensuring compliance with FinCEN (US) or FINTRAC (Canada) reporting requirements. Thorough documentation also makes investigating easier for organizations with a large caseload.
Integration with Claims Systems
Fraud investigators are busy people. They don't have time to search through every claim to see what cases need to be investigated.
With case management software, claims agents can flag content in your claims system that needs to be reviewed. This feature then automatically creates a case on that content right in the software for the SIU team to investigate. Your organization saves time and communicates more efficiently, speeding up investigations.
Automatic Filing
Manually filing all of your SARs to FinCEN can be confusing and time-consuming. With a case management solution, you can automatically file your organization's Suspicious Activity Reports within the software program. Eliminating manual filing saves time and leads to better compliance with reporting requirements.
RELATED: The Ultimate Guide to Insurance Fraud Investigations
Everything In One Place
When investigators have multiple cases or more than one person is working on a case, having all the data in one place eliminates the need for collecting information from different sources and team members.
You will no longer need to track down forms, documents, or pieces of evidence. Everything can be uploaded into the case file, giving whomever is working on it a full picture of the investigation. You can even customize what each team member assigned to the case can view to protect sensitive information.
Task Reminders
No matter the size of your organization, keeping track of workflow can be difficult. With case management software, you can ensure your insurance fraud investigations stay on track with task reminders.
Everyone on the investigation team stays in the loop thanks to alert and notification features. Remind employees that they have a task due with notifications. Set alerts to go off when cases sit idle for too long. These features organize workflow to keep the team on track, reduce reporting time, and ensure nothing falls through the cracks.
Reporting Capabilities
Creating and analyzing reports takes a lot of time and effort. With case management software, you can generate an investigation report in seconds.
The built-in reporting tool allows your team to detect patterns and track trends of fraudulent behavior. Create graphs and charts using fraud type or other criteria to save hours of busy work and get straight to the analysis. You can even integrate these reports with maps to see which geographical areas are hot spots for insurance fraud.
This information provides valuable insight that helps you detect fraud faster and be more proactive in deterring fraudulent behavior.
RELATED: 3 Ways to Use Social Media in Insurance Fraud Investigations
Configurable Features and Fields
Every organization has different needs. Rather than spending time creating your own forms and filing systems, case management software can be configured according to your specifications.
Whether you want to set up automatic alerts for certain triggers, include templates for specific forms (like SARs), or customize options on your drop-down menus, case management software can be tailored to your organization. Using software made specifically for insurance fraud investigations streamlines the process, helping you work more efficiently.
Read more about how Case IQ can help you track and manage insurance fraud investigations here.
Investigating Insurance Fraud with Case Management Software
Insurance companies lose billions of dollars to insurance fraud each year. Faster, more thorough investigations and trend analysis can help to reduce losses.
Use case management software to streamline your insurance fraud investigation process, saving time and money.