Claims Management

Claims Management Best Practices

Atlas Claims Management will always act as our client’s advocate. Our Claims Management best practices include:

Claims Assessment & Improvement

Our Claims Management consultants work with the your insurance carriers to set up customized standards and procedures to insure prompt claim reporting, timely and appropriate communication with all parties. We continuously investigate available cost containment measures using our Claim Best Practices Assessment. Our goal – reduce your claim costs!

Relationships & Partnerships with Insurance Carriers

Our Claim Management consultants will assist you in developing the most effective team to handle your claims, working with your insurance carriers and third party administrators on getting qualified and dedicated adjusters that best fit your organization. We work toward the following:

• 3-Point Contact Within 24-Hours
  We will assist the client with setting up a 3-point contact process that will have a more effective approach to handling the claim.
• Dedicated claims contact
  Atlas will work with your dedicated claims adjuster to facilitate superior claim handling.
• Cost Containment
  We will require that controlling claim costs is a priority and will insist on having services such as Medical Bill Review, Pharmacy Management, Early Medical Case Management intervention for serious injuries or where complex medical issues are involved and a Preferred Provider Network.
• Proactive Claims Management
  We expect the claim adjusters to make every effort to expedite resolution of claims. This would include maintaining a monthly diary and utilizing appropriate resources in a timely manner.

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Supervisor/Management Training

Atlas’ Claims Management consultants are available to provide managerial training in the areas of timely claim reporting, accident investigation, Workers’ Compensation 101, and early return to work.

Telephonic Injury Triage

Telephonic Injury Triage is a unique and time-tested cost containment strategy in the mainland, and Atlas is taking the lead in Hawaii by making it available to our clients first. We have partnered up with Medcor, an experienced Telephonic Injury Triage, to reduce your Workers’ Compensation costs. In short, during the first notice of loss, a triage nurse will gather pertinent information directly from your employee, assess the nature and extent of the injury, determine the appropriate level of medical intervention, and make a referral if appropriate.

Claim Review Meetings & Summaries

Regularly scheduled claim meetings with the insurance company claim adjusters are important to facilitate open communication and to develop action plans to bring early resolution to the claim. Atlas’ Claims Management consultants will coordinate these meetings and will provide value by bringing forward ideas to help bring closure to the claim.

Atlas provides a Claim Review Summary Report highlighting critical discussions from the claim review meetings.

Timely Claim Reporting

Our Claims Management consultants will develop a Claim Reporting Guide that reflects all special handling procedures. This will be completed anytime you change insurance carriers.

The Claim Reporting Guides contain all special handling procedures, pertinent phone numbers, maps to the designated medical facilities and tips on how to handle employees or injured third parties. Atlas can even develop Claim Reporting Wallet Cards which can be used as a quick reference for managers when there is an injury.

Return to Work/Stay at Work

Our Claims Management consultants will assess the effectiveness of your current return to work program. We want to ensure our clients are taking a proactive role by:

• Managing the claim situation to contain costs and return injured employees to work as quickly as possible, and illustrating to managers and supervisors the skills and information they need to play their part in that process
• Stressing early return to work, either to regular or transitional productive work activities
• Recommending early rehabilitation intervention of possible long-term disability cases for the best approach to case management: early job placement, rehabilitation and/or retraining

Claims Consulting Services will assist the client in developing a written return to work policy.

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Claims Consultant Biographies

ROY SASUGA Claims Consultant, Client Consulting Services Roy joined Atlas in 2000 after spending 30-years on the insurance company side of the business as the Vice President and Claims Manager for Island Insurance. Roy’s expertise includes general liability, auto and property related claims. Roy has assisted many large commercial clients over the years and is an advocate for our clients to make sure that their claims are handled quickly and correctly. His knowledge of how the insurance carrier’s claims process works is invaluable to Atlas’ clients. Roy is a graduate from the University of Hawaii and is a member of the Hawaii Claims Association as well as a Continuing Education Instructor.

MARTIN BEARDEAUX Claims Consultant, Client Consulting Services Martin has been with Atlas as a Claims Consultant since 2008 and brings with him over 13-years direct experience as a workers' compensation (WC) claims adjuster and independent WC claims adjuster in Hawaii.  As a seasoned claimse professional, he has represented carriers, third party administrators and self-administered organizations.   Prior to joining Atlas, Martin was part of the BlueWave Technology team developing the latest generation of claims management software. Martin is on the Board of Hawaii Claim Association (HCA) and is on the advisory panel for the Hawaii Independent Insurance Agents Association (HIIA).  He is a graduate of the University of Phoenix.

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