TSI’s Audit
Time and Money Saver Database (ATMSD) is designed and built by
TSI to enable senior claims management and auditors to develop “Best
Practices” claim file and operations standards using real
time claim file and operations audit data to assess current performance
against existing standards while gathering the information required
for continuous improvement of those standards and claims performance
against them.
TSI’s ATMSD allows the auditor to:
- Develop categories against which a file or operation is
going to be audited and populate those categories with best
practice
standards in an easily accessible format so the auditors can
validate compliance against them in an effective manner.
- Develop
weighted best practice standards that clearly identify mandatory
standards that when failed cause the entire file
or operation to fail regardless of compliance with all other
standards
applied to the file or operation.
- Auditors spend all of their
time auditing and analyzing findings so they can work with
management of the audited area
to develop
action plans that when implemented will bring them into compliance
with the standard. The database keeps real time statistics
and collates them to produce a final statistical report with
the
push of a button.
- Auditors can conduct daily summary reports
of the day’s
activity across multiple audit teams and share the preliminary
findings with management of the audited area.
- Auditors can
deliver final audit reports within days of completion of
the audit because they only have to analyze the
data and add
recommendations with action plans.
- Auditors can respond
to the challenges of specific findings, recommendations and
actions required to become compliant
in real time because they can immediately
produce accurate file specific findings that support their recommendations
and action plans.
- Management of the audited area will believe and accept
the recommended action plans required to come into compliance
with the company standard
because the
auditor can produce documentation of the findings in real time.
- The
database can be run as a stand alone Database or can be integrated
into the companies claims management system and databases.
- The database
is programmed to score the performance by audit category
and individual standard at the file, operation, business unit,
branch, region and national office levels at a detail or
summary
level.
- The database comes populated with TSI Best Practice
Standards by Category by Type of Claim so the company without
clearly defined
standards can immediately use it to conduct an audit.
- The
database can easily be tailored to accept company specific
standards and changed scoring if so desired by the client.
TSI has developed this database from the perspective of our
many years of experience in claims performance management and
the experience
of those clients to whom we have consulted over many years.
TSI Audit Time and Money Saver Database can be acquired in the
following ways depending on the requirements of the client:
- Acquire the specifications and tailor them to your needs
and systems. One of the major tasks of any information
technology database
projects is the writing of the specifications. TSI
has already done that so you can use our work as a straw
model and only modify
in those areas required to meet your unique specific
needs.
- Acquire the Database and have TSI tailor it to
your specific needs.
- Acquire the Database as is and use
it to conduct your audits with TSI providing training in
its use to your auditors.
- Acquire the Database by contracting
with TSI to do a Claims Operational Review using the Database.
All four options have pluses and minuses depending on your particular
needs. TSI would be pleased to meet with you to help you perform
a cost benefit analysis of the approach that best manages your
needs within the context of your budget.
|