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[Video] Claims/Legal for Power Users
- Log into Ideagen Healthcare Guardian.
- Click on the Claims app icon in Ideagen Healthcare Guardian Home to access it.
- Click on the claim you wish to review to open it. This will bring up the completed Claims form with all the details.
- An investigator can be assigned to the claim here.
- Every field that has been answered within the claim can be reported on. You also have the option to make localised, additional questions mandatory.
- To add an action to the claim, click on the key action to open it in a pop-up window.
- Here, you can add the action details, such as start, completion and due dates, assign the action to an owner and add a description.
- At the bottom, you can decide whether this action is specific to quality improvement, whether it’s a risk, or whether it impacts an incident. You can choose something within the system that it impacts.
- The claim system logs let you know the date the claim was logged and track the claim through every stage of the process.
- You then have a number of action buttons at the bottom so you can either reject this claim, save it as essential, or confirm or close it.
- Once this stage is complete, the claim will enter a new workflow stage. This workflow can be customised to your preferences.
- At the end of the workflow, the claim can be closed.
- You also have the ability to look at claims at any point in time, as well as claims specific to a certain user.
- In the claims action tracker, you can see the progress of the actions that have been created and who they're assigned to and the performance of the actions within the system as you can within any area of the platform.
- Finishing off in the claims area, you have the option of different dashboards that are already pre-built within the system. You can also amend these yourself.
- You can have the monthly report, which gives the number of claims, the claim cost type, and claim approval claim by stage, or we can go into a filtered report where we can have some pre-populated filters such as either clinical negligence or privately insured or any of the responses is captured within the form.
- To search for a claim, use the search area to search for specific criteria that match the claim you’re looking for.
- You can also use the slicers at the top of the page to filter the information.
- When you’ve found the right claim, double-click to open it in a pop-up window. This will let you view or amend anything within the claim.