P&C Workers' Comp and Auto

Property and casualty organizations deal with a wide array of hurdles and challenges. Some of these issues are shared with their commercial counterparts while others are unique to the P&C on their own. Having a front-end partner who understand the nuances of the workers' compensation space is critical to fully supporting your inbound workflows.
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Affiliations and Partnerships

Whether is a first report of injury, bills, or other claim information, Smart Data Solutions offers a full service front-end solution to meet your needs.

P&C Workers' Comp

E-Bills and Attachments

Not all clearinghouse solutions are the same, especially when it comes to the Workers’ Compensation and the P&C market. Smart Data Solutions understands these unique requirements:

  • You need a clearinghouse who knows the difference between a bill and a claim.
  • You need a clearinghouse who understands and can identify first report of injury or loss notices.
  • You need a clearinghouse that can provide attachment support for both payers and providers for the electronic bill workflow.

P&C Workers' Comp

Claim Matching

Associating your bills with claims can be a challenge for some payers. By referencing patient information, dates of accident, or any other claim identifiers present on the claim, Smart Data Solutions is able to match received bills to your active claim rosters. This ensures that all bills have an appropriate association made prior to submission to the adjudication systems.

P&C Workers' Comp

First Reports

First reports may go by a number of names across the industry: First Report of Injury, First Notification of Loss, etc. No matter the name of the submission, these first reports of injury must be identified and handled appropriately. In some cases, a bill may precede any first reporting and then becomes the first reporting. Having a front-end workflow to identify, track and report all of these first reporting cases quickly and accurately is crucial for the downstream claim management process.

P&C Workers' Comp

E-Bills and Attachments

Not all clearinghouse solutions are the same, especially when it comes to the Workers’ Compensation and the P&C market. Smart Data Solutions understands these unique requirements:

  • You need a clearinghouse who knows the difference between a bill and a claim.
  • You need a clearinghouse who understands and can identify first report of injury or loss notices.
  • You need a clearinghouse that can provide attachment support for both payers and providers for the electronic bill workflow.

P&C Workers' Comp

Claim Matching

Associating your bills with claims can be a challenge for some payers. By referencing patient information, dates of accident, or any other claim identifiers present on the claim, Smart Data Solutions is able to match received bills to your active claim rosters. This ensures that all bills have an appropriate association made prior to submission to the adjudication systems.

P&C Workers' Comp

First Reports

First reports may go by a number of names across the industry: First Report of Injury, First Notification of Loss, etc. No matter the name of the submission, these first reports of injury must be identified and handled appropriately. In some cases, a bill may precede any first reporting and then becomes the first reporting. Having a front-end workflow to identify, track and report all of these first reporting cases quickly and accurately is crucial for the downstream claim management process.

Customized Workflow Solutions

Smart Data Solutions offers a complete front-end workflow for P&C payers. We have solutions for bills, attachments, claim matching, and first reports but we know your needs don’t end there. Let us know what your pain points are, and we can share our expertise and best practices to help find the easiest solutions to your problem.

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1200+
SOWs written per year
7 TONS
tons of mail per week
500M
transactions annually
400+
Clients

Frequently Asked Questions

Can SDS perform claim matching?

+
x

SDS can perform claim matching for your P&C / Work Comp bills.  We can match the bills against your active claim rosters. We can also trigger first report alerts if we detect you may be receiving the bill before any other reports of injury or loss. 

Can SDS accept e-attachments?

+
x

Smart Data currently handles e-attachments for a number or our clients.  Our system can post these separately or hitched to the primary document.

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CLIENT TESTIMONY

Debbie Ziegler

“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs ...”
View Story
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CLIENT TESTIMONY

Brian Janssen

“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development ...”
View Story
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CLIENT TESTIMONY

Matthew Estes

“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us ...”
View Story

CLIENT TESTIMONY

Debbie Ziegler

Executive Director of Operations
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
View Solution

CLIENT TESTIMONY

Brian Janssen

VP, System Solutions
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
View Solution

CLIENT TESTIMONY

Matthew Estes

Chief Information Officer
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
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