With claim submission rates – and fraud rates – rising steadily, handling large volumes of claims quickly and accurately is a critical task, especially as cases approach their final approval hearings. Administrators are often required to review hundreds of thousands, or even millions, of claims within tight timelines. Relying solely on manual processes or basic technology is not only inefficient but also risks jeopardizing case outcomes.
6.5 Million Claims to Review in Five Days
In one recent case, a claims administrator was tasked with processing over 6.5 million claims within just five days before the final approval hearing. The administrator lacked the tools necessary for rapid processing, and manually reviewing each claim or using simple SQL queries was impractical. As a result, the judge withheld final approval due to the incomplete analysis.
This situation illustrates a significant challenge in claims administration: the influx of vast numbers of claims creates the need for a robust, scalable solution capable of processing claims accurately and on deadline. Traditional methods simply fall short when claims volumes escalate to such levels. Manual review processes are time-consuming, and SQL queries, while useful for filtering data based on basic criteria, are inadequate for detecting sophisticated patterns of fraud or distinguishing between legitimate and fraudulent claims that share similar characteristics.
Leveraging Advanced Technology to Meet Approval Deadlines
Once the administrator in this case implemented ClaimScore, the outcome was vastly different. The software processed the 6.5 million claims in under three days, delivering accurate, data-proven results that could be confidently presented in court. The judge, relying on the comprehensive analysis, granted final approval for the case. This example highlights the importance of having the right technology in place to manage mass claims efficiently and accurately.
ClaimScore uses advanced algorithms and a data-driven approach to allow administrators to automate and streamline the review process for millions of claims. ClaimScore’s technology goes beyond simple SQL queries. Its sophisticated tools and intelligent analysis capabilities can detect fraudulent claims patterns that traditional methods might miss.
For instance, while SQL queries might filter out claims based on one-off criteria, ClaimScore’s system analyzes multiple data points simultaneously, using machine learning to differentiate between similar claims and flag anomalies that may indicate fraud. This level of analysis ensures that legitimate claims are not unfairly dismissed while fraudulent claims are identified with precision.
Given the current landscape of class action claims fraud, claims administrators need more than basic tools to meet the demands of large, complex litigation with large numbers of claims. By adopting ClaimScore, administrators can streamline their processes, reduce the risk of errors, and ultimately, secure the successful resolution of cases with confidence, in compliance with court deadlines.
To learn more on how to build a successful class action settlement, check out our new ebook, ”Best Practices in Class Action Claim Validation: A Checklist.”
