Claims Management Toolkit

Save time, empower your teams and effectively upgrade your processes with access to this practical Claims Management Toolkit and guide. Address common challenges with best-practice templates, step-by-step work plans and maturity diagnostics for any Claims Management related project.

Download the Toolkit and in Three Steps you will be guided from idea to implementation results.

The Toolkit contains the following practical and powerful enablers with new and updated Claims Management specific requirements:

STEP 1: Get your bearings

Start with...


• The latest quick edition of the Claims Management Self Assessment book in PDF containing 49 requirements to perform a quickscan, get an overview and share with stakeholders.


Organized in a data driven improvement cycle RDMAICS (Recognize, Define, Measure, Analyze, Improve, Control and Sustain), check the…


• Example pre-filled Self-Assessment Excel Dashboard to get familiar with results generation


Then find your goals...

STEP 2: Set concrete goals, tasks, dates and numbers you can track

Featuring 996 new and updated case-based questions, organized into seven core areas of process design, this Self-Assessment will help you identify areas in which Claims Management improvements can be made.

Examples; 10 of the 996 standard requirements:


1. When compared to the service offered by direct sales channels, what potential advantage do individual healthcare insurance customers have by purchasing through independent intermediaries?
   
   

2. Is service excellence something to strive for because that is what will add the most value to the brand or will functional customer service be adequate for what the brand represents?
   
   

3. Is the substantial similarity test adequate to address claims of infringement based on outputs from a generative AI system, or is some other standard appropriate or necessary?
   
   

4. Is there a process to reconcile amounts billed to paid/accepted claims within ten business days of receipt of reports/remittance advice and resubmit claims as indicated?
   
   

5. What are the evolving areas of best practice for provision of savings and insurance products to the poor and underserved, particularly within the digital space?
   
   

6. Which department within your organization verifies that the cyber insurance coverage is sufficient for the risk associated with the services received?
   
   

7. Is the prudential assurance deal an early indicator of the start of a larger and more fierce technology arms race within the insurance industry?
   
   

8. What are the main contributions of digital technology and the use of data to the relationship among industrial customers and the suppliers?
   
   

9. What is the main advantage to being a member of a large corporate private medical insurance scheme compared to having an individual policy?
   
   

10. What would you estimate to be the average value of claims for which your organization could potentially use commercial legal finance?
    
    


Complete the self assessment, on your own or with a team in a workshop setting. Use the workbook together with the self assessment requirements spreadsheet:


• The workbook is the latest in-depth complete edition of the Claims Management book in PDF containing 996 requirements, which criteria correspond to the criteria in...


Your Claims Management self-assessment dashboard which gives you your dynamically prioritized projects-ready tool and shows your organization exactly what to do next:


• The Self-Assessment Excel Dashboard; with the Claims Management Self-Assessment and Scorecard you will develop a clear picture of which Claims Management areas need attention, which requirements you should focus on and who will be responsible for them:
  
  


• Shows your organization instant insight in areas for improvement: Auto generates reports, radar chart for maturity assessment, insights per process and participant and bespoke, ready to use, RACI Matrix

• Gives you a professional Dashboard to guide and perform a thorough Claims Management Self-Assessment

• Is secure: Ensures offline data protection of your Self-Assessment results

• Dynamically prioritized projects-ready RACI Matrix shows your organization exactly what to do next:



STEP 3: Implement, Track, follow up and revise strategy

The outcomes of STEP 2, the self assessment, are the inputs for STEP 3; Start and manage Claims Management projects with the 62 implementation resources:


• 62 step-by-step Claims Management Project Management Form Templates covering over 1500 Claims Management project requirements and success criteria:


Examples; 10 of the check box criteria:


1. Scope Management Plan: Does a documented Claims Management project organizational policy & plan (i.e. governance model) exist?
   
   

2. Scope Management Plan: Have Claims Management project management standards and procedures been identified / established and documented?
   
   

3. Team Performance Assessment: To what degree will the approach capitalize on and enhance the skills of all team members in a manner that takes into consideration other demands on members of the team?
   
   

4. Lessons Learned: What were the main sources of frustration in the Claims Management project?
   
   

5. Initiating Process Group: Are you certain deliverables are properly completed and meet quality standards?
   
   

6. Probability and Impact Assessment: Do requirements demand the use of new analysis, design, or testing methods?
   
   

7. Team Operating Agreement: What resources can be provided for the team in terms of equipment, space, time for training, protected time and space for meetings, and travel allowances?
   
   

8. Procurement Audit: Are periodic audits made of disbursement activities?
   
   

9. Initiating Process Group: Do you understand the communication expectations for this Claims Management project?
   
   

10. Probability and Impact Assessment: Do requirements put excessive performance constraints on the product?


 
Step-by-step and complete Claims Management Project Management Forms and Templates including check box criteria and templates.

1.0 Initiating Process Group:


• 1.1 Claims Management project Charter

• 1.2 Stakeholder Register

• 1.3 Stakeholder Analysis Matrix


2.0 Planning Process Group:


• 2.1 Claims Management project Management Plan

• 2.2 Scope Management Plan

• 2.3 Requirements Management Plan

• 2.4 Requirements Documentation

• 2.5 Requirements Traceability Matrix

• 2.6 Claims Management project Scope Statement

• 2.7 Assumption and Constraint Log

• 2.8 Work Breakdown Structure

• 2.9 WBS Dictionary

• 2.10 Schedule Management Plan

• 2.11 Activity List

• 2.12 Activity Attributes

• 2.13 Milestone List

• 2.14 Network Diagram

• 2.15 Activity Resource Requirements

• 2.16 Resource Breakdown Structure

• 2.17 Activity Duration Estimates

• 2.18 Duration Estimating Worksheet

• 2.19 Claims Management project Schedule

• 2.20 Cost Management Plan

• 2.21 Activity Cost Estimates

• 2.22 Cost Estimating Worksheet

• 2.23 Cost Baseline

• 2.24 Quality Management Plan

• 2.25 Quality Metrics

• 2.26 Process Improvement Plan

• 2.27 Responsibility Assignment Matrix

• 2.28 Roles and Responsibilities

• 2.29 Human Resource Management Plan

• 2.30 Communications Management Plan

• 2.31 Risk Management Plan

• 2.32 Risk Register

• 2.33 Probability and Impact Assessment

• 2.34 Probability and Impact Matrix

• 2.35 Risk Data Sheet

• 2.36 Procurement Management Plan

• 2.37 Source Selection Criteria

• 2.38 Stakeholder Management Plan

• 2.39 Change Management Plan


3.0 Executing Process Group:


• 3.1 Team Member Status Report

• 3.2 Change Request

• 3.3 Change Log

• 3.4 Decision Log

• 3.5 Quality Audit

• 3.6 Team Directory

• 3.7 Team Operating Agreement

• 3.8 Team Performance Assessment

• 3.9 Team Member Performance Assessment

• 3.10 Issue Log


4.0 Monitoring and Controlling Process Group:


• 4.1 Claims Management project Performance Report

• 4.2 Variance Analysis

• 4.3 Earned Value Status

• 4.4 Risk Audit

• 4.5 Contractor Status Report

• 4.6 Formal Acceptance


5.0 Closing Process Group:


• 5.1 Procurement Audit

• 5.2 Contract Close-Out

• 5.3 Claims Management project or Phase Close-Out

• 5.4 Lessons Learned


Results

With this Three Step process you will have all the tools you need for any Claims Management project with this in-depth Claims Management Toolkit.

In using the Toolkit you will be better able to:


• Diagnose Claims Management projects, initiatives, organizations, businesses and processes using accepted diagnostic standards and practices

• Implement evidence-based best practice strategies aligned with overall goals

• Integrate recent advances in Claims Management and put process design strategies into practice according to best practice guidelines


Defining, designing, creating, and implementing a process to solve a business challenge or meet a business objective is the most valuable role; In EVERY company, organization and department.

Unless you are talking a one-time, single-use project within a business, there should be a process. Whether that process is managed and implemented by humans, AI, or a combination of the two, it needs to be designed by someone with a complex enough perspective to ask the right questions. Someone capable of asking the right questions and step back and say, 'What are we really trying to accomplish here? And is there a different way to look at it?'

This Toolkit empowers people to do just that - whether their title is entrepreneur, manager, consultant, (Vice-)President, CxO etc... - they are the people who rule the future. They are the person who asks the right questions to make Claims Management investments work better.

This Claims Management All-Inclusive Toolkit enables You to be that person.

Includes lifetime updates

Every self assessment comes with Lifetime Updates and Lifetime Free Updated Books. Lifetime Updates is an industry-first feature which allows you to receive verified self assessment updates, ensuring you always have the most accurate information at your fingertips.