INSURANCE TECHNOLOGY

Payers achieve CMS Interoperability compliance and complete member visibility with Redox platform

Redox | November 03, 2021

Redox announces their payer-specific interoperability solution. This expansion of Redox's platform allows payers to meet current and future CMS regulatory requirements while also enabling connections with providers, partners and vendors. As a result, payers can access the data necessary to unlock administrative efficiencies, understand the breadth of member journeys, and improve care.

The CMS Interoperability and Patient Access final rule mandates that payers enable patients to access payer-hosted clinical and claims data upon a patient's request via third-party applications. Payers must also make provider directories publicly available for third-party applications. In 2022, those mandates will expand such that payers must exchange data with other payers at a patient's request. Further proposed are additional interoperability mandates focused on providing electronic access to prior authorization requests.

Redox connects payers to the data and applications needed to keep pace with a rapidly shifting healthcare and technology landscape.   

Redox solves data interoperability for:
  • Electronic prior authorization Connect providers and payers to streamline the $30 billion existing prior authorization process to reduce administrative waste.
  • Closing Care Gaps Receive clinical information for your member population and send insights back to providers to ensure best practice guidelines are met and that all care team members are in sync.
  • Integrating digital health solutions Power data exchange between the growing ecosystem of third-party applications used in managing patient populations and individual patient health.
  • Direct Scheduling Build superior member experiences by enabling real-time scheduling with any provider in your network.

"Large payers already know that Redox has the most extensive network in the healthcare data interoperability space, and they are using Redox's platform as a strategic advantage, Although the mandates aren't yet urgent, payers are moving quickly to adopt them because those payers are already benefiting from its efficiencies."   

- Garrett Rhodes, Product Manager for Payers at Redox.

About Redox
Redox accelerates the development and distribution of healthcare software solutions with a full-service integration platform to securely and efficiently exchange healthcare data. With just one connection, data can be transmitted across a growing network of 1,700+ healthcare delivery organizations and 300 independent software vendors. Members of the Redox Network exchange more than 20 million patient records per day, leveraging a single data standard compatible with more than 85 electronic health record systems. Redox exists to make healthcare data useful and every patient's experience a little bit better.

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INSURANCE TECHNOLOGY

TrueMotion Joins Guidewire PartnerConnect Solution Alliance Ecosystem

TrueMotion, Guidewire | February 10, 2021

Guidewire Software, Inc. the platform P&C insurers trust to draw in, advance, and develop efficiently, today announced that TrueMotion, Inc., a main platform for smartphone telematics, has joined Guidewire PartnerConnect as a Solution partner to offer a claims accelerator powered by smartphone telematics data. The companies likewise announced that TrueMotion's new Ready for Guidewire approved accelerator is presently accessible to insurers in the Guidewire Marketplace. TrueMotion's Ready for Guidewire telematics accelerator flawlessly connects TrueMotion's platform to Guidewire ClaimCenter, empowering agents to access crash-scene telematics data directly inside ClaimCenter. At the point when a crash occurs, data like location, time, speed of impact, and climate is automatically accessible for agents to check with the insured at First Notice of Loss (FNOL), smoothing out the claims data collection process for all included. TrueMotion pinpoints the crash location and driving occasions when a crash for coverage examination. Agents can review the crash location with a completely coordinated Google Street and Map view with a collision indicator. With TrueMotion's telematics data, agents can likewise check whether the insured visited a hospital following the crash. This data helps agents ask policyholders the correct inquiries and decide the correct injury group to contact if necessary. With TrueMotion’s telematics accelerator for ClaimCenter, adjusters can: Save time and administrative burden because telematics and crash data are automatically pre-filled with the click of a button; Quickly understand the details of a car crash through an automatically generated, fact-based description of what happened during the incident; and Verify claims information and handle claims faster and more efficiently to improve the claims experience overall for the insured. According to a J.D. Power study, “satisfaction with the claims experience affects customer retention and referrals”, among satisfied claimants, over 80 percent said they “definitely will” renew their policy and recommend their insurer, contributing to as much as 30% higher profitability. Making the claims experience simple and positive for insureds can help considerably with customer retention and loyalty. “We are proud to partner with Guidewire to offer a claims accelerator powered by smartphone telematics data,” said Cornelius Young, Vice President, Claims, TrueMotion. “We’re excited to offer our shared customers the ability to access telematics data directly in ClaimCenter, boosting their efficiency and simplifying their workflows. Adjusters will be able to eliminate redundant tasks, reduce manual entry, and focus on the customer’s needs to get them back on the road sooner.” “We are delighted to welcome TrueMotion as our latest Guidewire PartnerConnect Solution partner and collaborate in helping our joint customers leverage telematics to transform the claims experience,” said Neil Betteridge, Vice President, Strategy, Guidewire Software. “TrueMotion’s integration can help improve the speed and quality of auto claims handling for both adjusters and policyholders.” About TrueMotion, Inc. TrueMotion provides the world’s leading smartphone driving data platform. Powered by machine learning, the platform determines when a person is driving, reveals their behaviors behind the wheel, and detects crashes. Insurers, automakers, app developers, telcos, and fleets use TrueMotion data to fuel their pricing, claims, safety, acquisition, and retention programs. Nine of the top 20 US insurers and leading insurers in Canada and Europe rely on TrueMotion technology. TrueMotion is based in Boston with offices in Budapest. About Guidewire PartnerConnect ecosystem and Ready for Guidewire Guidewire PartnerConnect Solution partners provide software, technology, and data solutions as well as insurance support services. Our Solution partners help drive business value and innovation for insurers by developing and delivering integrations, extensions, apps, and other complementary solutions for Guidewire products. All of our Ready for Guidewire partner solutions are validated for security, quality, and compatibility with Guidewire. About Guidewire Software Guidewire is the platform P&C insurers trust to engage, innovate, and grow efficiently. We combine digital, core, analytics, and AI to deliver our platform as a cloud service. As of the end of our fiscal year 2019, more than 380 insurers, from new ventures to the largest and most complex in the world, run on Guidewire. As a partner to our customers, we continually evolve to enable their success. We are proud of our unparalleled implementation track record, with 1,000+ successful projects, supported by the largest R&D team and partner ecosystem in the industry. Our marketplace provides hundreds of applications that accelerate integration, localization, and innovation.

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Constellation Affiliated Partners Acquires Coastal Insurance Underwriters and Cybercom

Constellation Affiliated Partners, RedBird Capital Partners, Coastal Insurance Underwriters | December 29, 2020

Constellation Affiliated Partners (Constellation) today announced the acquisition of Coastal Insurance Underwriters (Coastal) and Cybercom. Financial terms of the transaction were not disclosed. Through the acquisition of Coastal and Cybercom, Constellation will continue to expand its product offerings to the Condominium Association and Homeowner’s Association marketplace. “These new business classes complement many of our existing programs and will provide increased product access to our clients,” said Bill Goldstein, CEO of Constellation. “The Coastal and Cybercom team bring a wealth of knowledge and innovative web-based programs. Their proprietary technology platform and deeply experienced underwriters will be a great addition to our growing portfolio of innovative, high-quality MGAs, program administrators, and wholesalers in the insurance industry.” Coastal Insurance Underwriters, founded by President/CEO Charles “Chuck” Bushong in 2007, is an insurance program administrator providing unique products to the Community Association marketplace. Coastal underwrites property, general liability, crime, D&O, golf & country club, equipment breakdown, workers’ compensation, inland marine, umbrella, small business, and private flood insurance products. Coastal currently underwrites insurance in Florida, California, Alabama, Texas, Georgia, Kentucky, and Tennessee. “Over the last 13 years Coastal has grown to offer a multitude of unique insurance products and cutting-edge technology designed to meet the needs of the ever-changing insurance marketplace,” stated Bushong. “We look forward to accelerating our growth as part of the Constellation portfolio of companies, utilizing Constellation’s established relationships to continue to diversify our programs and expand our footprint throughout the U.S.” “This powerful tool quotes, underwrites, binds, and issues insurance policies to agents in real-time,” added Bushong. “The platform was designed to leverage automation and provide agents with a simple, 24/7 solution to even the most complex insurance opportunities, while providing carriers access to timely underwriting data and risk exposure information.” Cybercom currently provides technology development services to Coastal and third-party clients throughout the country. “The acquisition of Coastal and Cybercom demonstrates Constellation’s commitment to technology-enabled and data-driven programs and to the continued diversification of programs and product offerings available throughout our company,” commented Goldstein. About Constellation Affiliated Partners Constellation Affiliated Partners is a New York-based insurance consolidator platform that specializes in acquiring MGA, program administrator and wholesale companies in the United States and Canada. Constellation's partners use a set of core values to evaluate and pursue strategic partnerships with companies that have demonstrated superior underwriting principles and have earned a solid industry reputation. The diverse group of companies within Constellation's portfolio bring a vast array of insurance and re-insurance offerings to the North American marketplace. Constellation is backed by RedBird Capital Partners, a private investment firm focused on building high-growth companies with flexible, long-term capital. About RedBird Capital Partners RedBird Capital Partners is a private investment firm focused on building high-growth companies with flexible, long-term capital in partnership with its Entrepreneur & Family Office Network. Founded by former Goldman Sachs Partner Gerry Cardinale, RedBird today manages $4 billion of capital principally across its core industry verticals in Sports, TMT, Financial Services and Consumer. RedBird invests with an entrepreneurial, company-building mentality, with an emphasis on capital appreciation and compounding equity returns over longer holding periods. RedBird’s network of business founders and entrepreneurs is central to its investment sourcing strategy, and its highly curated group of limited partners are active co-investors who provide scalable capital support. For more information, please go to www.redbirdcap.com About Coastal Insurance Underwriters Coastal Insurance Underwriters, Inc. founded in 2007 is a program administrator specializing in designing, creating, and managing insurance products for a variety of business classes, including condominium associations, homeowner associations and golf and country clubs. Coastal has grown to become one of the largest Managing General Underwriters in the United States focused on community association products with over 8,000 homeowners and condominium associations currently insured. Coastal continues to advance in automation to ensure that they remain on the cutting edge of changes necessary in this marketplace. They continue to develop and launch new products and expand into additional states. Coastal will continue to strive to be a leader in providing highly specialized, and financially sound insurance products through automated and simple-to-use solutions. About Cybercom Cybercom International Corporation, Inc. was established in 1997 as a custom software development company in Ponte Vedra Beach, FL. During the past 23 years, Cybercom has been building high-performance enterprise-level applications for a number of vertical markets, including insurance, e-commerce, industrial, medical, and manufacturing. Coastal acquired the assets of Cybercom on January 2, 2020. Cybercom’s capabilities include new product development, existing product support, analytical reporting, document generation, third-party integration, and workflow automation. In the insurance marketplace, Cybercom has built tools for a number of coverage lines, including Property, General Liability, Crime, Directors & Officers, Umbrella, Commercial Auto Liability, and more.

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INSURANCE TECHNOLOGY

Damco Solutions Partners with omni:us to Fast-Track Insurers Adoption of Data-Driven Cognitive Claims Management

Damco Solutions, omni:us | December 07, 2020

Damco Solutions Inc., leading innovation solutions and digital services company, has announced the partnership with omni:us, an Artificial Intelligence as a Service (AIaaS) provider to fast-track insurers adoption of data-driven cognitive claims management. Backed with more than two decades of IT experience, profound insurance domain information, and industry-demonstrated ability in arising advancements, Damco Solutions would leverage omni:us remarkable capabilities to help insurance businesses accelerate their pace of digital transformation. This partnership would uphold insurers to rapidly convey AI into their claim's lifecycle streamlining the interactions among insurers and safeguarded parties. The combination of Damco's Insurance industry experience, innovation capability with omni:us ability in AI would give exceptionally differentiated digitization services assisting insurers with reevaluating the claims venture with high impact automation. Below is a snapshot of omni:us capabilities: Digital FNOL: Real-time claims management that converts information into actionable claims data by minimizing touchpoints with intelligent claim automation Claims Indexation: AI cognitive process that streamlines document extraction and classification to read, interpret, and understand data by eliminating the manual workflow Completeness Check: AI-powered claims handling process with AI-powered decisions and recommendations, providing insights for regulatory compliance and reducing manual claims touchpoints Coverage Check: Intelligent claims automation improving productivity in the claims process by eliminating time-intensive tasks, identifying noncovered claims, detecting fraud, claims leakage, etc. "We look forward to collaborating with omni:us to help insurance companies with AI-based cognitive claims management solution and digital technologies to simplify claims lifecycle," said Mohit Gupta, Founder & Chief Executive Officer, Damco Solutions Inc. "Together, we would be able to help a broader range of insurers industrialize innovation in claims management. With the addition of omni:us, we see tremendous opportunity to enlarge our approach and help more businesses supercharge their future-readiness." "omni:us and Damco share a common aspiration: to drive insurance businesses towards a more efficient and customer-oriented experience", said Sofie Quidenus-Wahlforss, Founder & Chief Executive Officer, omni:us. "We at omni:us are excited to team up with such a veteran player in the field as Damco. Both sides will benefit from the other's strengths and specializations and be further empowered to realize our ultimate goal of bringing about wide digital transformation to the insurance sector." About Damco Damco Solutions is the trusted technology partner of businesses worldwide enabling them to leverage IT as a strategic asset. Empowered by technology expertise, immaculate execution capabilities, and unwavering focus on the customer needs; Damco has nurtured businesses to connect with their customers, clients and employees in an entirely new way. Damco and omni:us partnership aim to deliver data-driven AI-based solutions for streamlining the claims ecosystem, driving efficiency, collaboration, and bringing the digital future to global insurance businesses. About omni:us omni:us is an Artificial Intelligence as a Service (AIaaS) provider for cognitive claims management. Built on a fully data-driven approach, omni:us transforms the way insurers interact with their insured parties. It provides all the necessary tools and information to make fast, transparent and empathetic claims decisions, whilst improving operational efficiency and reducing loss adjustment expenses.

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