Claims

Atlanta-based Blue Cross and Blue Shield of Georgia has launched the Clear Claim Connection, an online product and service for its network providers. This product, created by McKesson Corp., enables BCBSGa to share with network providers the auditing rules and clinical rationale which exist in the claims billing and auditing code system used by BCBSGa.John Watts, president and chief executive officer of BCBSGa, says, "This important service will enable network physicians and their office staffs to review our payment methodology online. By providing this service, we hope to make our reimbursement policies more readily accessible and reduce misunderstandings among providers, members and BCBSGa."

NEW YORK--The Guardian Life Insurance Co. of America is making an effort to demystify the financial planning process and educate visitors on the role that Guardian's products and financial representatives play in an overall financial planning strategy. The company is doing it with a new Web site, located at www.GuardianLife.com. The new site replaces Guardian's existing Web address at www.glic.com.

In recognition of the HIPAA security rule pre-anniversary deadline that passed this month, Washington, D.C.-based nonprofit URAC released a report examining the state of preparedness in the health care industry in complying with the security rule.

Columbus, Ohio-based Nationwide Financial is using Web technology to make it easier for investment professionals to manage the client review process with a new tool called the Interactive Client Review (ICR).Nationwide's ICR tool simplifies the client review process by providing one-stop, real-time access to client portfolios online. Detailed information is presented in a concise and secure format for investment professionals to access from any remote location. The ICR tool can also provide investment professionals with a quick, easy view of their clients' quarterly statements online. Through its instantly accessible electronic format, ICR aims to help investment professionals manage their clients' accounts in half the time.

New York-based MetLife has introduced a new online Individual Disability Income (IDI) Broker Portal designed to simplify the policy application and case management process for brokers by providing access to real-time information.Through the IDI Broker Portal, MetAccessIDI.com, brokers can immediately obtain underwriting case status, underwriting requirements and client policy information, including policy status and payment history. In addition, required applications and forms can be downloaded through a link from the site. The portal also features a private message board providing brokers with a convenient channel for communicating with MetLife IDI Underwriters regarding their cases.

Toronto-based Manulife Financial Corp. and John Hancock Financial Services Inc., Boston, including its Canadian subsidiary, The Maritime Life Assurance Co., completed their merger after receiving all necessary regulatory approvals. John Hancock is now a subsidiary of Manulife Financial.John Hancock stock will cease trading on the New York Stock Exchange at the close of markets today, April 28, 2004. The approximately 675,000 John Hancock common shareholders are entitled to receive 1.1853 Manulife common shares for each John Hancock common share. John Hancock shareholders overwhelmingly approved the combination on February 24, 2004, with more than 95 per cent of the votes cast favouring the adoption of the merger agreement.

Each year, more insurers appear to be increasing their budgets in implementing sophisticated fraud detection systems; however, the majority of these investments are centered around post-payment fraud detection rather than detecting fraud prior to claims being paid.

Los Angeles-based Marshall & Swift / Boeckh (MS/B) will be acquired by MacDonald, Dettwiler and Associates Ltd., Richmond, B.C., Canada.MDA is a global information company providing property-specific information to businesses and governments. Operating through two groups Information Products and Information Systems, MDA is active in data collection, information extraction, and information distribution.

Tufts Health Plan has selected and deployed a software platform for e-billing, e-payment, and online customer care from edocs, Natick, Mass. By enhancing its existing site with the edocs applications, Tufts HP is offering comprehensive functionality for enrollment, billing, reconciliation and payment.

Denver, CO--Valen Technologies, a provider of intelligent predictive analysis and decision enabling software, announced the availability of a premium modification module for its predictive underwriting software, Risk Manager. The new module develops a sophisticated, multivariate pure premium model that underwriters use on a daily basis to surcharge and discount policies more effectively.

The Hartford Financial Services Group has made it easier for agents to obtain a personal lines standard auto quote in minutes -- even as their customers wait for the answers. A major proponent of single entry multiple carrier interface (SEMCI) for personal lines business, The Hartford is one of the first carriers to implement this technology breakthrough that allows agents to connect directly with their carriers through AMS-Rackley's new SETWrite rating platform to obtain an accurate rate.

Corporation's Human Resources & Investor Solutions (HR&IS) business today announced that it has developed a fully integrated Health Savings Account (HSA) solution that will be offered both through alliance relationships with insurance companies and health care plan providers, and to its corporate customers nationwide.

Preferred Medical Claim Solutions (PMCS), Scottsdale, Ariz., and Genelco Software Solutions, a division of Greenville, S.C.-based Liberty Insurance Services Corporation (LIS), have formed a strategic partnership that will provide Genelco Group+ users access to the Preferred Data Interchange (PDI) offered through PMCS. Genelco Software Solutions provides administration software and services to life and health insurers."A number of Genelco Group+ users wanted the claim funding and repricing that PMCS provides," says Mike Molinar, vice-president of Genelco Software Solutions. "Knowing that this will save our clients money, we thought it very important to provide a seamless way for them to take advantage of the PMCS network."

San Diego, CA--WorldGroup has introduced InsureWorx First Report of Injury (FROI), the latest InsureWorx On Demand Solution (ODS). The new FROI capabilities offer exceptional efficiency and customer service to the First Report of Injury process, enabling efficient and timely intervention - critically important to controlling overall costs of workplace injury claims. The company launched the solution at RIMS Annual Conference & Exhibition.

SAN DIEGO, CA---Assurex Global, the world's largest privately held risk management, commercial insurance and employee benefits broker group, is launching new software to enhance communication and information-sharing among its independent broker partners and commercial clients around the world. The software was introduced here at the Risk and Insurance Management Society's annual conference.

ChoicePoint, Alpharetta, Ga., has entered into a definitive agreement to acquire the assets of Superior Information Services LLC and Charles Jones LLC, Trenton, N.J., for a combined total purchase price of $89 million in cash. The acquisitions are scheduled to close on or before May 1, subject to customary closing conditions and regulatory approval.Superior Information is a provider of public records information for bankruptcies, civil judgments, and federal and state tax liens in the Northeast U.S. and works closely with Charles Jones in sharing data and services. Charles Jones is a leading supplier of title and property lien searches in New Jersey and has provided a variety of public record data services to title insurance companies and real estate markets since 1911. Superior Information and Charles Jones have a combined total of 300 employees.

Prudential Financial Inc., Newark, N.J., has launched a new online disability claim submission application for employees of group disability clients. The new functionality also lets employees handle many aspects of their claims using a highly secure and confidential online process."Continuing to provide our clients and their employees with the secure tools they need to effectively manage disability issues is of paramount importance to us," says Al Hemond, vice president of disability risk management for Prudential's group insurance business. "Online employee claim submission supports our strategy of providing claims management services that are responsive to the varying needs of claimants."

SunGard Sherwood Systems, an operating unit of SunGard today announced that Wawanesa Mutual Insurance Company, one of the largest property and casualty insurers in Canada, has licensed SunGard's FrontTier solution to replace its existing legacy policy, billing, workflow and claims systems.

COLUMBIA, S.C.-- BlueCross BlueShield of South Carolina will promote two executives to top positions over BlueCross' major group division and Companion HealthCare when a key senior officer retires in June.

S2, a new service offering from CBC National Inc., Saddle River, N.J., and ARI (Automotive Resources International), Mt. Laurel, N.J., was launched as part of a strategic partnership between the two subrogation recovery and salvage/remarketing industry players. According to the companies, the new venture was built on the premise that no company should let money slip through its fingers.Responding to the needs of the insurance industry, the rental car industry, and a variety of other self-insured and government entities, S2 provides clients with aggressive subrogation resale services that are designed to positively impact their bottom line.