Claims Administration Services

Spectrum Administrators provides the claims adjudication services of experienced Claims Representatives leading processing teams through the gamut of claim management activities. We understand the special claims handling needs and interests of the self-insured employer and recognize the importance of maintaining positive employer-employee relationships while minimizing loss exposure.

Services include:

• Claim Creation, Investigation and Loss Reserving
• Claim Management
• State Self-Insurance Renewals
• Claim Reviews
• Bill Repricing
• Bill Verification and Disbursement Issuance
• Management of Service Providers
• Financial Services/Banking Management

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Loss Control

Risk control and loss prevention serve as the core of our practice. Our commitment to being "more than just a claims company" sets us apart from our competitors. We have developed, and continue to refine and expand our loss control service lines in an effort to streamline workers' compensation programs by reducing workplace risk, educating managerial staff and enhancing employer-employee relations through expression of genuine concern for employee safety.

Components of our loss control program include:

• Policy and Procedure Review and Development
• Review and enhancement of intake systems and forms
• Composition of Provider Panels
• Inservice Education
• Statistical Reporting
• Loss Control Committee Participation
• Return to Work Programs

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Data Management and Reporting

At Spectrum Administrators, we recognize the positive impact early intervention via prompt claim reporting has on the complexity of a claim. As well, our focus on risk identification and loss trending requires the ability to develop a sophisticated bank of loss data. Spectrum Administrators employs MCO Advantage, a system which, through our customization, meets our high technological standards and collects significant data. It offers the ability to simply and accurately generate reports using that data to present clear and concise pictures of the status of individual claims and the claims program overall.

Major system capabilities include:

Recording and maintaining data, and generating detailed reports on individual claims, aggregate experience, specific and general injury characteristics, claim, allocated, and non-claim expenses, reserve histories, banking, and other general financial information relative to a self-insured program.

Remote access technology allowing our clients secured, straightforward access to their data, note screens, diary, etc.

An unmatched selection of statistical, claim and financial reports, including loss runs, check registers, easy-to-read financial reports, OSHA logs and IRS form 1099 are available.

The base of data maintained on claims is flexible, extensive, multi-dimensional, and relates directly to many national databases because of several multi-tier coding schema.

Electronic transmission of data to the state when permitted. State forms are on-line for ease of completion.

Case and protocol management features, which allow comparison of prescribed treatment to standards for similarly situated, injured workers.
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Statistical and Activity Reports

• Statistical and activity reports are integral facets of, and useful tools for both claims administration and risk reduction.
• Spectrum Administrators has devised report formats which capture injury statistics, claim data and information about expenditures made, in a clear, concise and easy-to-follow manner.
• Reports generated are used internally for claim management, preparation of graphs used in reporting injury data, evaluating program costs, scheduling file reviews and the payment of indemnity benefits.
• Other reports can be supplied to the client for use in reviewing claim and program status.
• We offer a broad selection of standard statistical and activity reports as well as a nearly unlimited range of ad hoc/custom reports.
• Any and all data entered and maintained in the database is available for reporting.
• We design custom reports, spreadsheets and graphs as indicated to best inform our clients and demonstrate their program accomplishments and/or needs.

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