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Frequently Asked Questions About Risk Manager
1. How long is an online demonstration?
Depending on the number of attendees an average demonstration will take about two hours or as long as questions are asked. Demonstrations can be scheduled to begin as early as 7:00 am Pacific time and up to nine (9) persons in nine (9) separate locations can participate. ERIC Systems utilizes GoToMeeting by Citrix Systems to conduct online demonstrations.
2. Do you offer onsite demonstrations?
Once an online demonstration has been provided, if a more in-depth review of Risk Manager is desired, we'd be happy to provide a demonstration at your site for all persons interested in knowing more details. Selecting a claims administration application is a big decision. We believe all persons who would be working with Risk Manager, in any capacity, should have an opportunity to learn how it might affect their job function.
3. Will Risk Manager work with SQL SERVER 2005/8 Express Edition?
Absolutely! This version of SQL Server 2005 has some limitations, like the maximum number of concurrent users, but for startups and smaller organizations it's ideal for getting started at the least possible cost.
4. We have existing data we want to save. Can you import it into Risk Manager?
We certainly can. There are standardized file formats that are used to exchange data between different computer systems. We haven't met a data set yet that we couldn't import. If the data source contains: claimant data, vendor information, financial transactions, notes, documentation of coding schemes used, and the organizational structure, we can create a Risk Manager database that will have you operational within as little as 30 days. Data conversions can be a one or two step process. Two step is recommended. We suggest budgeting between $5,000 and $7,500 per data source for this service.
5. Is Risk Manager web-based?
Risk Manager is a client-server application written in VB6 (10%) and .NET (90%). It isn't designed to be run from within a web browser. In order to do that, we'd have to sacrifice one of the most important features of our program design, our user interface. We also believe opening your company's network for access by the world is just inviting trouble. The better question is... Can Risk Manager be accessed via the Internet? The answer to that question is absolutely yes. Risk Manager is very compatible with terminal services and popular third-party applications that provide remote access to centralized databases. Many of of clients use software by Citrix Systems for this purpose Is ERIC Systems an Applications Service Provider (ASP)? No, we are not. An ASP is an organization leases software by providing remote access to an application installed on a server located in its location.
6. Can Risk Manager handle the Electronic Data Interchange (EDI) reporting requirements that are mandatory for the States we do business in?
Risk Manager supports EDI for a variety of purposes. For example:
- IAIABC Release 1 and 3 standards as required by many States
- Proprietary State electronic reporting standards such as SIEDRS for the State of Washington.
- Positive Pay files to enhance check security
- ACH (Direct Deposit) payments for claimants, spouses, other payees, and vendors
- Import and export of third-party bill review data
- Import and export of claimant eligibility files and payment information for pharmacy benefit plans.
- Import of State Medical Fee Schedule data
- Import of leased Preferred Provider Network (PPN) contract data.
- Special extracts to meet specific client requirement
- Form 1099-MISC Electronic Filing
- Import of the US Department of the Treasury, Office of Foreign Assets Control, Specifically Designated Nationals (SDN) list for comparison to payee files.
7. Which Risk Manager version is right for my company?
This is a question that requires a good understanding of the nature of your organization and what types of information you wish to obtain from the Risk Manager database.
All versions of Risk Manager have the same set of features and capabilities. The differences between versions are based on four (4) primary factors:
- Number of organizational levels needing to be defined.
- The ability to customize claim and financial data coding schemes
- The need to comply with HIPPA privacy regulations
- Regulatory reporting requirements
Organizational Structures - The design of Risk Manager provides an extremely simple and flexible mechanism for grouping business units for loss reporting. ERIC Systems uses the generic terms enterprise and employer to identify the top two levels of organizations structure that may be defined for separating and grouping data. An employer is generally, but not always, defined as the smallest business unit authorized to be self-insured by a State agency. In a general liability and P&C environment, an employer would be the smallest business unit to be issued a policy.
Within an employer or location, six sub levels of organization are possible. Not all levels need to be used. Levels within the employer can be bricks and mortar based (hierarchical, like an org chart) or used to combine claims by using activities common to many locations. For example, within a school district one level 4 could be used to identify the activities of food services, janitorial, teacher, student, administrative, and possibly facilities. Using a standard report and specifying that the grouping be by level 4 would show losses for each activity exclusive of location.
In the private sector, an enterprise will most likely be a collection of one or more related self-insured employers grouped together for financial reporting purposes. In a public agency, an enterprise can be defined as the City or County with the first level Departments defined as employers. In States allowing retrospective rating groups, an enterprise would be defined as Association registered with the State. In States where worker compensation insurance is provided by private carriers, an enterprise would be equivalent to the Association formed to administer claims. In general liability and property & casualty environments, an enterprise or insured would be a holding company of related employers or locations grouped for combined loss reporting. The primary differences between versions include the following:
The multi enterprise version of Risk Manager is the most flexible version offering the ability to define an unlimited number of enterprises each with an unlimited number of associated employers or locations. The single enterprise version provides for only one enterprise with an unlimited number of employers. The single enterprise, single employer version number of Employers within a single Enterprise, and Single-Employer allows one Employer within a single Enterprise. The number of possible organizational levels by program version:
- Enterprise = 8
- Single-Enterprise, Multi-Employer = 7
- Single Enterprise, Single Employer = 6
Access rights to view claim data is both function-based and employer-based. Program logins can be limited to one, many, or all employers and then to only specified rights assigned by the system administrator. In all Risk Manager versions, logins can be limited to one organizational unit at one organizational level. This includes all units subordinate to that unit.
Claim and Financial Data Coding Schemes - In order to standardize the collection of information for groups of related employers, all but two data coding schemes are defined at either the enterprise or system levels. The Enterprise version is strongly recommended for mixed Worker Comp and P&C environments to allow reserving and accident/injury codes to be tailored to the specific requirements of each function.
HIPPA Privacy - Although the administration of worker compensation claims is exempted from HIPPA regulations, considerations must be given to privacy when administering both worker compensation (WC) property & casualty (P&C), and general liability (GL) claims within the same database. Since Risk Manager security is implemented primarily at the Employer level, WC, P&C, and GL claims should be managed within separate Enterprises. This will both maximize flexibility and allow user security logins to be configured to restrict those responsible for GL and P&C claims administration from viewing medical data associated with WC claims.
Regulatory Reporting Requirements - Many State and Federal agencies now require claims information to be submitted periodically, by electronic means, for a variety of purposes. Since every agency wants the data for a different purpose, they all define unique standards and coding schemes to meet their individual objectives. Given that classifications of business units cannot be “free-form”, consideration of how organizational structures will affect reporting requirements must be a factor in choosing the right version of Risk Manager.
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