FileHandler is a browser-based claims administration tool designed to help manage multiple lines of business including Workers Comp, Auto, Liability, and Property.
FileHandler functionality includes robust security, detailed policy info, note, diary, email, as well as litigation and subrogation screens. A full payment module includes vendor maintenance, payment entry, optional custom checks, and bank account reconciliation. FileHandler integrates with MS Word for user defined correspondence.
Business rules allow organizations to custom design workflows through a series of trigger events improving productivity. The custom screen development tool allows users to create screens that integrate seamlessly into the FileHandler system. The billing module renders clients the capability to bill their files by a flat fee or T&E as well as tracking receivables within the system.
Different levels of customization are available to further meet business requirements including accounts payable, positive pay interface, and OFAC verification. Medical and pharmacy review interfaces are designed to import payment information into the system from a third-party review software system. FileHandler provides additional ISO reporting for protection from fraud. Document imaging has the ability to scan and attach multiple documents to the claim file. FileHandler supports jurisdictionally required forms and letters. MSP and state EDI Reporting are available as well.
General Claims Management Functionality
General Claims Management Functionality
- Reporting Dashboard
- Correspondence Module
- Policy Maintenance
- Billing Module
- Business Rules
- Vendor Database
- Check Printing Module
- Integrated E-mail
- Custom Screen
JW incorporates FileHandler Security, a fully integrated security component specifically designed for HIPAA-compliant security administration in FileHandler.
FileHandler Security allows for individual-user, role-based accounts with multiple users leveraging the same roles. Permissions at the most granular level (by page, drop-down menu, data field, etc.) may also be customized on a user-by-user basis to further define the role designation for that particular user.
This approach benefits system administrators by not requiring special roles for specific individual users when variance from another established role is minor. Each user also has a unique user id and HIPAA-compliant password.
All authority limits are set in FileHandler Security and based on a per claim limit as well as a per payment limit broken down by reserve group. Both payment and reserving authority along with the corresponding workflow is client-defined through FileHandler Security and the FileHandler Business Automation Tools.
For example, when a user exceeds their authority level (defined in FileHandler Security) a diary, email or note can automatically be generated to the user’s supervisor requesting approval.
FileHandler Security is a powerful yet intuitive tool that both simplifies and streamlines security administration while maintaining the highest level of standards for data security and integrity.
FileHandler’s reporting capabilities are divided between four key components:
- FileHandler Reporter
- FileHandler Risk Analysis Reporting Engine
- FileHandler File Audit Query
- FileHandler Dashboard
The FileHandler Reporter includes over 60 standardized reports such as loss runs, claim list reports, 1099 reports, and safety analysis reports. Reports may be generated in a variety of formats including .PDF, .xls or .doc file types. Security is configurable so that clients can grant access by role or group including report-only access.
Full sorting and filtering capabilities are provided including ending, beginning and full wildcard filters. Reports may also be scheduled to run on any interval, i.e., daily, weekly, monthly, quarterly, etc. and distributed via e-mail and/or the Electronic Report Distribution Tool (see below).
Included as the second of FileHandler’s four reporting tools, the FileHandler Risk Analysis Reporting Engine is a fully integrated reporting engine that allows for real-time claim, financial and workload queries of the database based on a virtually unlimited set of criteria, defined by the user from a set of pick-list menus.
Pie Charts and Bar, Column and Line Graphs in a PDF format may be immediately created with the resulting data set based on a variety of metrics including claim counts (open, closed, reopened, total) along with Paid, Outstanding, Recovered and total dollars.
For further analysis, the tool provides an on-line, real-time ‘drill down option’ based on specific data elements defined by the user. The user may export the captured data into Microsoft Excel so as to save the results and apply additional MS Excel functionality, i.e., Pivot Tables, etc. In addition, “drill-down” results are displayed in the same screen as opposed to opening up a separate results screen. This dynamic tool provides a simple mechanism for quick analysis tailored to the specific needs of the user.
The FileHandler Dashboard organizes claims and performance information and displays the data in a variety of options:
- Data Set: The real-time data from the user-defined snapshot is provided with a “drill-down” feature for real-time access and analysis of the electronic claim file. Data may also be instantly exported to MS Excel for further analysis.
- Gauge: Real-time data may also be displayed in a gauge format with the user defining both the floor and ceiling parameters so as to measure performance based on user-defined metrics.
- Graph: Real-time data may also be presented as a graph either on-line or printed as a PDF report.column chartbar chartline chartpie chart.
In addition to the real-time interface, the FileHandler Dashboard incorporates an automated alert system which allows organizations to define, track and benchmark quantifiable measurements or key performance indicators (KPIs) with notifications of KPI breaches automatically sent via e-mail to appropriate claims stakeholders.
Offered as an alternative vehicle by which to deliver automated reports, FileHandler integrates into the product the Electronic Report Distribution Tool, a user-customized function that provides a centralized repository of customized, auto-generated reports which are automatically updated based on user-defined specifications.
Claim lists, loss runs, workload reports, etc., are updated daily, weekly, monthly, etc., depending on user requirements with a red numerical indicator on the main claim page notifying users with each login the number of new dashboard reports created:
FileHandler’s reporting tools are intuitive and extremely flexible. All four tools were designed with the user in mind while being cognizant that each client has unique needs and differing data requirements. We feel this design approach has greatly benefited our clients, providing them powerful reporting tools to meet the most stringent reporting requirements.
The FileHandler Correspondence Module is an integrated tool for the generation of claim-related documentation.
The module leverages MS Word and merges data fields from within the database into one of several available document formats in the FileHandler forms library. The benefits of this module are numerous, including:
- Insertion of Letter Head information (graphics, etc.)
- Customization of Headers and Footers
- Elimination of redundant data entry
Any correspondence that has been generated is tracked in the database and stored at the claim level. Security can be applied to the module to allow view-only access for those documents that have been sent. In addition, documents can also be automatically generated and populated as part of the FileHandler Business Automation Module.
The FileHandler Policy Module is made up of a Master Policy table, Coverage Table, Location Table and Class Code Table.
The Master Policy and Coverage tables track basic policy data such as Policy Holder, Effective Dates, Limits, Excess Retention, and Deductibles, etc. Each reserve type is tied to a coverage code, which enables FileHandler to track losses by policy, and by coverage.
In addition, FileHandler supports the configuration of coverages with multiple layers of insurance (including self-insurance). The Policy Maintenance module also includes an “On-Call Notice Percent” user-defined column that tracks when a Self-Insured Retention limit has been exceeded. Users can be automatically notified of SIR erosion via diary and/or e-mail via a user-defined business rule configured through the FileHandler Business Automation module.
For Carrier and MGA clients requiring a fully integrated, end-to-end claims and policy administration solution, e.g., application processing, issuance, commissions, billing, audits, cancellations and reinstatements, JW Software offers PolicyHandler, a web-based, .NET Workers Compensation Policy Management System. Both systems share the same database and provide workers compensation MGAs and Carriers a seamless, web-based insurance technology solution.
FileHandler incorporates a fully integrated billing module within in the application.
This module provides clients the ability to bill their files either via a flat fee or time and expense and subsequently track receivables in the system.
- Flat Fee – User Defined Billing Schedules may be set up allowing files to be billed on a flat rate basis on a schedule and rate that are defined by the client.
- Time & Expense – FileHandler allows for clients to configure user-defined billing codes and billing services for itemized service billing. The T&E billing component provides for the adjuster the power to post their own time directly into the system. Client and user specific billing rates can be set up affording our clients enormous flexibility when billing files.
Invoices are printed directly from FileHandler and cash receipt maintenance is integrated in the system.
FileHandler integrates a variety of billing reports, which allow our clients to see outstanding invoices and cash receipt maintenance. Some examples:
- Invoice Register
- Cash Receipts Register
- Client Aging
- Interim Billing
Users have the ability to notate the entire claim file via FileHandler’s Notes functionality.
The system allows for unlimited numbers of notes to be entered on each individual claim with each individual note virtually limitless as it relates to the amount of the text that may be entered into each specific note. Data in the note may either be manually keyed in or cut and pasted from other documents, notes, e-mails, etc.
Each note that is entered into the system is date and time stamped with the user login ID attached to the note entry.
Users may configure the system so that data entered in the note is written in a rich HTML format allowing the text to be manipulated in a variety of ways included multiple font options, differing text/background color, highlighting, etc.,
In addition, note text may be checked for spelling via FileHandler’s integrated spell-checker and user-defined note types may be attached to each note to be used as a data point for sorting, filtering and/or reporting.
Notes are displayed in a two-box scrolling format:
Note text is displayed in the bottom box with the top box providing the header information of the specific note text displayed. Information in the header box can be sorted, filtered and in the event the user would prefer a printed copy of the note or notes, the note report button provides a quick report in a PDF or HTML format.
The notes function also allows for a keyword search of the note text as well as filtering functions by user, date range, claim party and handler.
Security is configurable on the notes screen to allow for a variety of access configurations. For example, security is configurable to only allow access to certain note types for specific users, or notes can only be editable for ‘x’ number of days after entry.
Note reports from within the specific note screen within the claim file may be generated in either HTML or PDF with HTML preserving the color/font, etc., changes. In addition, reports generated with data from the Notes page support changes to color and font as well.
FH Mail, which also supports HTML rich-text format, is accessible from the Note Page enabling users to attach diaries to an e-mail and forward to any applicable parties.
Completely integrated as part of the base product, FileHandler incorporates the FileHandler Business Automation Module, a tool that allows your organization to custom design workflow through a series of automated business rules designed to drive specific actions.
The system currently offers over 40 unique business rule ‘templates’ that can be customized to automate workflow in variety of client environments. Based on a qualifying action in the system, each business rule triggers either one or a combination of pre-defined actions, specifically:
- E-mail – a specific person or group of people are notified of via e-mail with appropriate attachments (see correspondence)
- Diary notification – a specific person or group of people are notified via diary
- Note entry – a pre-defined note is entered into the claim file
- Correspondence – a piece of customized or standardized correspondence is generated and either attached to an e-mail, attached to the claim file or both.
- Automated Reserve – a client-defined reserve type and amount are set based on a qualifying action
Users are notified via a pop-up screen when a qualifying event has occurred and the results of the business rules triggered by the qualifying event. Users also have the ability to configure a ‘prompt’ prior to an action occurring so as to override.
For example, a business rule may be configured to automatically create a reserve upon new claim entry however the business rule can be configured so when the business rule is executed, the user has the option each time to approve or disapprove the automated reserve.
This engine serves as a powerful tool to automate many processes and improve productivity in your claims organization.
FileHandler fully integrates a vendor database that is designed to track all pertinent vendor information including contact information, vendor notes and 1099 information.
User-defined vendor-type coding may be leveraged for reporting purposes.
Vendor information is sub-categorized into four distinct components:
- Detail/Main information – Vendor’s name, address, phone, fax, tax ID number, and 1099 type is captured. This page serves as the main contact and mailing address for a particular vendor.
- Locations – A vendor can have multiple locations and mailing addresses all tied back to a central 1099 type and tax ID.
- Contacts – Multiple contacts may be tied to vendors.
- Notes – Vendor notes may be entered into the system and tied to specific vendors.
FileHandler’s integrated diary functionality provides a comprehensive tool that allows both adjusters and supervisors to track and monitor claim activities.
The FileHandler diary system is segregated into three key components: the Claim Diary Page, the Diary Audit Page and the Diary Calendar:
- The Claim Diary Page – The Claim Diary Page displays all the diaries that relate to that specific claim. Diaries are displayed similar to the Notes page: two boxes with the diary header information above and the diary text below.
The Claim Diary Page is the key repository of all claim activity and therefore may contain diaries from a variety of stakeholders on the claim. Users have the ability to sort, filter and report on individual claim diaries. In addition, electronic files may be attached to individual diary entries from the Claim Diary Page.
When entering a diary, the system provides a real-time diary audit for the specified diary date. This allows for users to appropriately schedule diaries and not overload specific days.
When the work related to an open diary is completed, the user may mark the diary as “worked”, which hides the diary from view, giving the user a quick snapshot of only the remaining open diaries. For those diaries that have been worked, the user may view those by filtering out the “worked” diaries. Simply hovering over the “worked” label provides a “bubble date” detailing the specific day the diary was indeed worked.
FH Mail is accessible from the Claim Diary Page enabling users to attach diaries to an e-mail and forward to any applicable parties.
- Diary Audit Page – The Diary Audit Page is designed to provide users a snapshot of all diaries that are due across all the affiliated claim files. This page also serves as comprehensive auditing tool for supervisors, providing them a real-time view of their adjuster’s workloads.
The page is configured to provide a list of all the diaries that have either been manually or automatically generated for that particular adjuster with the page defaulting to display the newest diary first. The page displays the user, diary date, diary status, diary text and other applicable information.
The page is configured to allow for sorting and filtering against a variety of data components, for example: diary date range, diary type, diary status, line of business, handler, supervisor, etc. Users also have the option to advance and delete groups of diaries as well. For those users who desire a paper-based report, the system will generate a quick report of the displayed diaries via the report button on the Diary Audit Page.
To access the actual Claim Diary page, users may either select the diary individually and pull open the claim on the workbench or select a host of diaries and pull several claims to the workbench.
- Diary Calendar – The Diary Calendar is a dynamic diary “calendar view” that provides the end-user a daily, weekly or monthly snapshot of upcoming diary events that have either been manually generated via a system user or automatically generated via the FH Business Rules Engine.
Diaries that are displayed may be reviewed within the calendar, advanced to a day in the future or deleted. To access the actual Claim Diary page of the displayed diaries, users may either select the diary individually and pull open the claim on the workbench or select a group of diaries and pull several claims to the workbench
Fully integrated into the base system, The FileHandler Check Printing Module allows for checks to be printed on one of 3 pre-defined check stock types.
Checks are printed by checking account, and each checking account can have one of the three unique check stock types associated with. The module is configured so that the checks are printed on pre-printed, MICR-coded check stock.
Additional check stocks and/or customization of existing check stock is invoiced on a time and expense basis. Destroy, alignment and test printing is allowed and accounted for in the end accounting process.
FileHandler integrates a litigation-tracking component within the system that is designed to capture litigation information relative to the individual claim file, specifically:
- Court, Judge and Jury Notes
- Plaintiff and Defendant (including associated parties) information
- Anecdotal Liability Analysis (including plaintiff and defendant) negligence %
- Litigation Cost Tracking
- Demand Amount
- Offer Amount
- Low Cost to Defend
- High Cost to Defend, etc.
- Anecdotal Evaluation Analysis
- Litigation date status tracking (motion, petition, discovery dates, etc.)
- Deposition date tracking
- Litigation Note tracking
In addition to the data mentioned above, users also leverage the other tools in the system (FileHandler Mail, FileHandler Correspondence, FileHandler Document Imaging, FileHandler Notes/Diaries, FileHandler Reporter, etc.) to provide a fully comprehensive litigation tracking mechanism that can be used by attorneys and claims handlers alike, with all claim stakeholders sharing data in real time for immediate access to pertinent litigation and claim information.
FileHandler Mail is a fully integrated function for sending and receiving Email from within the FileHandler claim file.
E-mails that are generated from FileHandler have the claim ID imbedded in the e-mail so that any replies are automatically routed through the FileHandler windows service application and entered into the File.
Emailing capabilities are available throughout the entire system. For example, notes, diaries, letters, special handling instructions, etc., may be e-mailed however all e-mail sent and received are centrally tracked on the claim e-mail page.
From within the e-mail page users have the ability to sort and filter on incoming, outgoing and/or deleted e-mails for that particular claim, view attachments from each individual e-mail or forward to another e-mail address.
For outgoing e-mails, a user may configure the system so that data entered in the e-mail is written in a rich HTML format so that text may be manipulated in a variety of ways including multiple font options, differing text/background color, highlighting, etc., In addition e-mails may checked for spelling via FileHandler’s integrated spell-checking tool.
FileHandler fully integrates a custom-screen development tool which allows users to create custom screens that integrate seamlessly into the FileHandler system.
Such flexibility provides clients a mechanism to respond to data tracking and reporting changes in real-time as opposed to having to engage the vendor and pay additional customization fees and wait for the upgrade to be released.
Clients have a variety of options as it relates to the design, layout and placement of custom pages within the application, specifically:
- Custom screens may be created and displayed at the claim or party level
- Clients are provided the ability to create a new table in the database or use a pre-existing table
- Custom screens may apply to specific Lines of Business and/or specific Clients
- Navigation labels for both the custom screen and custom elements within the screen are entirely user-defined
- Specific data elements may be configured by type, i.e., character, decimal, text, etc.
- Specific data elements may pull from selection lists including pre-existing user-defined codes in the database, i.e., location, department, loss condition, etc.
Lastly, clients also have the option to customize validation properties, i.e., the data inputted must be between specific numerical ranges, the data inputted must be in a standard format, e.g., SSN, etc. If the data cannot be validated, the user may create its own custom error message to be displayed within the system.
Modules and Interfaces
Modules and Interfaces