About Us

Technology - e-Claims

One of the greatest claims processing advantages offered by CRMC is its electronic claims processing system. In January, 2002, CRMC introduced its e-Claims™ system technology (patent pending), a new concept in claims processing. E-Claims™ is designed to speed claims processing, increase efficiency, and lower costs by moving from paper claim forms received by mail to claims filed electronically over the world wide web: e-filing. It should be noted that while the emphasis is on e-filing, CRMC maintains the flexibility to process both paper and electronically filed claims.

With the e-Claims™ system, claims and supporting documents arrive electronically or are imaged upon receipt, decreasing the cost of handling and storing the documents. CRMC claim intake methods include paper submissions sent by mail or fax, direct data entry by law firms through the internet, and batch upload from a law firm’s data base. Batch uploads can be submitted in various media, including spreadsheets and flat (ASCII) files transferred by CD-ROM or by e-mail. CRMC utilizes its Online Document Information System (ODIS) to eliminates storage and handling costs by imaging and indexing paper documents upon receipt. Claim forms, medical, exposure and other supporting documents are readily available to Quality Control personnel, and are accessible to the filing law firm.

Claims are initially evaluated by executing the e-Claims™ system’s Categorization Decision Tree (CDT), a revolutionary concept geared to programmatically determine claim value based on a series of questions and answers. At the option of the CRMC client trust, information can be input into the CDT either by a claimant’s law firm or by CRMC staff. Additionally, quality control is built into every process and audits are performed both before and after settlement offers. The bottom line is that the e-Claims™ system reduces claim settlement costs, decreases processing delays, and reduces the number of times a file must be “touched” by everyone involved.

Claimants electing, or requiring, individual review are valued using one of e-Claims™ system’s newest features, the Individual Review (IR) sub-system. This sub-system determines claim values by referencing a series of comparable claim results (comps) based on historical data elements such as lost wages, jurisdiction, age and number of dependents, medical costs, or any other elements that a particular client trust identifies.

Offers and/or denials associated with a claim categorization process are generated automaticlly upon completion of the CDT. The results are presented to the user in a clear and concise manner detailing the CDT responses and value determination. IR offers are immediately presented to electronic filers outlining the options available to them.

The CRMC makes communication with its law firm filers and its client trusts the focus of its efforts. The e-Claims™ system enables law firms to review claim data, get status reports, accept/reject offers and send messages to CRMC Customer Relations Analysts. Client trusts will be able to access reports 24/7, and each trust will have a service representative.