1. MANAGING HPL CLAIMS UTILIZING ADVANCED ANALYTICS

2. ABOUT THE SPEAKER Sharon Malloy –Origami Risk – Sales Executive »Implementation Specialist Origami Healthcare clients –Previously with Marsh ClearSight (STARS)

3. GOALS Reduce Claims Reduce Costs Promote Quality Care

4. KEY ELEMENTS Notifications Analysis and Comparison Attorney Scorecards Reports – Key Identifiers

5. NOTIFICATION Automate collection – immediate capture of adverse events –Workstation – limited time to capture events –Narrative fields to capture event –Pick lists to provide analysis Routing rules Scheduled tasks Supporting documentation Rules based communication tree

6. COLLECT AS MUCH DETAIL AS POSSIBLE…

7. ROUTING Routing rules –Multiple streams based on data collected at the time of the event –Communication tree

8. SCHEDULING Require follow up on scheduled time lines Send notification of due dates Regular schedule for attorney status reports Make it easy and quick

9. DOCUMENTATION AND COMMUNICATION Supporting documentation –Notes – security based on need to view –Files – security based on need to view –Templates Rules based communication tree Negative impacts of poor communication or flawed processes in responding to claims

10. ANALYSIS AND COMPARISON Analysis and Comparison –Use data to identify trends and drivers –Similar claims – what does history tell me –Expected outcomes

11. RATING Attorney Scorecards –Relate win/loss/settlement ratios to any factors tracked on claims –Distribute cases based on success rates –Overall score, communication –Adherence to guidelines and communication process

12. REPORTING Reports – Key Identifiers –Root Cause Analysis –Monitoring Analysis –Identify fraudulent claims early –Identify frequent flyers

13. BEST IN CLASS HPL CLAIMS MANAGEMENT Notifications Analysis and Comparison Attorney Scorecards Reports – Key Identifiers

14. THANK YOU See you at Annual Florida Society for Healthcare Risk Management and Patient Safety Annual Meeting & Education Conference will be held at the Embassy Suites Lake Buena Vista South August 12-15, 2015