CCMSI

Risk management is a continuous process of identifying, evaluating, and treating financial loss exposures that might emerge from inefficient workers’ compensation and property and casualty claims management. It enables employers to bring injured employees back to work quickly, while minimizing serious onsite disruptions and economic impact. However, the process of handling workers’ compensation claims often proves to be a daunting task for businesses owing to the presence of a vast array of legal, legislative, and compliance demands as well as state-specific regulations. In parallel, companies need to be mindful of the complications involving an aging workforce, narcotic use, and the growing cases of chronic conditions among injured workers that may make recoveries longer, complicated, and expensive. To rightly deal with these challenges, organizations need to partner with a third-party claim administrator that has extensive jurisdictional expertise.

This is where Cannon Cochran Management Services, Inc. (CCMSI)—a leading TPA for workers’ compensation and property/casualty self-insurance programs—steps in.

From its inception in 1978, CCMSI has built a strong reputation in the market by equipping clients with quality data and analytics for their risk management programs. “We have built a team of highly-experienced claims professionals who work collaboratively with clients’ internal risk management team to architect service instructions and interactive protocols for efficient claim management,” says Skip Brechtel, EVP, and CIO, CCMSI.

As a fully employee-owned company(ESOP), CCMSI has experienced employees with many working at CCMSI for many years. They play a vital role in fostering personal relationships with clients and making timely decisions. This, in turn, allows CCMSI to bring significant claim reductions with a positive impact on aged-loss portfolios and the management of new claims.

CCMSI’s workers’ compensation claim management service offering is based on three pillars—compensability investigations, medical management, and disability or RTW management. Using this, CCMSI shares the correct information pertaining to the workers’ compensation process, expectations, procedures, and benefits due to clients. As a result, the company can ensure the best and fastest claim outcomes. To make the process even more seamless, CCMSI has partnered with Gradient AI—an artificial intelligence firm with more than 45 million workers’ compensation claims in their data set.

CCMSI shares the claim data, adjuster notes, medical bills, and PBM bills with GradientAI for claim risk analysis and AI-based scoring models. The adjusters at CCMSI leverage this information as an additional tool to assist them in their claims handling processes. Not stopping there, CCMSI performs a secondary supervisor review if a large discrepancy arises between the incurred value estimated by an adjuster and projected by Gradient AI.

What enables CCMSI to provide such a comprehensive service is its proprietary risk management information system. It allows clients to view claims by type, date-ofloss, and more by using a long list of powerful, user-defined filters. The system has been built in-house with functionalities recommended by CCMSI’s seasoned claim professionals and clients. “We have close to 200 IT staff that makes necessary changes and system enhancements to help clients view all of their analytics and costs associated with each claim. CCMSI has also architected an industry-leading corporate claims training program that helps employees to hone both technical and non-technical skills. “Our comprehensive training program enables all the team members to enhance their adjusting skills. That’s why even during the pandemic when every industry was undergoing a bout of turmoil, we were able to handle the surge of COVID claims without compromising the quality,” Brechtel says.

Backed by an expert team and technology, CCMSI continuously strives to enhance AI capabilities to provide its adjusters with up to date information about a claimants’ journey. For example, our adjusting team at one time received an invoice with a PT report after 30 days of a claimant’s PT visit. Today, the company is close to building API capability to break that status quo and make the claim management process seamless with real-time information. For this, the company is partnering with quality medical service providers and vendors for IME, PT, Diagnostic and FCM/ TCM services. CCMSI also takes into account the psychosocial aspect of claimants to bolster its communication with them. This will enable adjusters to collaboratively work closely with the claimant through the claims management process.

“Our company has always been driven by the mission to be the best TPA, not the largest. We believe that our job is not only to deliver quality claims administration, but to provide our clients with quality data analytics, so they can better manage their risk management program to the highest level. Our mission has and will continue to be driving outstanding claim outcomes for our clients through technology, workflow applications and data analytics.” concludes Brechtel.