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The County of Los Angeles Expands Use of PCIS’ ClaimsVISION

Staff Writer | December 06, 2017

From the National Workers’ and Disability Compensation Conference & Expo, P&C Insurance Systems, Inc. (PCIS), a proven and trusted provider of risk management information systems (RMIS), claims administration and automated compliance solutions, today announced that the County of Los Angeles (the County) has signed a new contract expanding its relationship with PCIS. 

 

In production since 2015 with PCIS’ claims management suite ClaimsVISION® , the County’s Chief Executive Office (CEO) Risk Management Branch uses the PCIS system to manage and oversee workers’ compensation claims for all employees of Los Angeles County, the largest county (by population) in the United States. The County’s new contract expands use of ClaimsVISION’s automated E Compliance infrastructure with a new Financial Approval Hub, featuring auto-trigger integration to the County’s audit control system, a new Vision Legal module, the addition of County Counsel users, and EFT integration.  Key to the County’s utilization of ClaimsVISION is PCIS’ ability to achieve the County’s goal of 80% touchless payment transaction processing, driven by a complex network of business rules and auto-triggers. 

 

PCIS’ ClaimsVISION serves as the County’s single and centralized workers’ compensation claims system to provide efficient, highly automated, and streamlined claims processing. ClaimsVISION centralizes the County’s claims administration operation, hosting more than 900 users across four TPAs, interacting with more than a dozen third parties, and processing an average 27,000 open claims and 2,000 payments per day.

 

The PCIS system also acts as the hub for collaboration and coordination of data between the County, partner TPAs, PBMs, and MMCCs; requiring a unique infrastructure that allows for complex assignment, validations and approval rules, and affords the County the ability to rotate its roster of partners seamlessly.

 

The County’s anticipated benefits from its expanded use of PCIS’ ClaimsVISION include:

 

  • Fully automated “No Touch FROI/SROI Reporting” to the State of California;
  • Direct CMS Medicare reporting;
  • Surpassing the 80% touchless payment transaction processing objective;
  • Deployment of Vision Legal, legal case management, adding County Counsel users;
  • A financial approval hub for enhanced payment and a vendor compliance audit control system.

 

Steve Robles, Assistant Chief Executive Officer with the County’s Risk Management Branch, commented, “Our goal is to continually find ways and leverage the best technologies to improve our claims and compliance handling. We have been extremely pleased with PCIS and the system’s ability to provide touchless FROI/SROI reporting and to meet our gauntlet of financial reporting requirements in order to reach 80% touchless payment processing. When it came time to expand our case management capabilities and enhance our interface to Audit Control, PCIS was the obvious choice.”

“Our expanding partnership demonstrates the County’s success with and confidence in ClaimsVISION.  Through our joint efforts we continue to set the bar in the public sector with technological advances that leverage claims and risk management best practices.  Since its go live with ClaimsVISION, the County leads the state in No Touch FROI/SROI automation. With our latest modules, the Financial Approval Hub and Vision Legal, we are able to provide the next innovations in compliance and litigation management,” added Georgette Loizou, PCIS Executive Vice President. 


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