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Frequently Asked Questions About Risk Manager
1. How long is an online demonstration? Depending on the
number of attendees and how many questions are asked, an average
demonstration takes about two hours. 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 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
and .NET. 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. The application would
re
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) factors:
A. Number of organizational levels needing to be defined.
B. The ability to customize claim and financial data coding schemes
C. The need to comply with HIPPA privacy regulations
Organizational Structures
- The Risk Manager design 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:
Access rights 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.
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