LTCG Uses Sparkling Logic SMARTS™ Decision Management Technology for Claims Processing
SMARTS increases the efficiency of claims processing.
LTCG has enhanced its claims processing capabilities by implementing SMARTS™ Decision Management. LTCG is a leading provider of business process outsourcing to the long term care (LTC) insurance industry, administering over 1.3 million policies and processing more than 47,000 claims for many of the major insurance carriers for nearly two decades. The SMARTS system empowers organizations that need to automate and improve business decisions. LTCG uses SMARTS to increase the level of automation in its claims adjudication decision logic.
“Thanks to SMARTS, we were able to discover, test, and deploy automated claims decision logic in under six months,” said Kyle Korzenowski, LTCG CIO. “As a result, we have seen a reduction in the time required to process the most straightforward claims, which will improve customer satisfaction and allow our highly-experienced staff to focus on complex, high-cost cases.”
LTCG has demonstrated experience in improving the financial and operational performance of LTC carriers through its end-to-end solutions —from underwriting of new business to claims and administration of open and closed blocks. Within the area of claims management, the company uses its robust clinical expertise and claims experience to drive accurate, evidence-based decisions about eligibility and care plans while supporting active and ongoing clinical management. The addition of SMARTS adds another high-tech resource to complement this high-touch approach.
“LTCG already has the highly-skilled people, clinical expertise, and operational best practices needed to position their organization for success,” said Davorin Kuchan, Sparkling Logic CEO. “Now we are proud to be part of their claims-processing solution representing their commitment to investing in the latest technology.”
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LTCG is the leading provider of administrative solutions and clinical services to the long term care insurance industry, with nearly two decades of experience in this space. LTCG currently manages over 1.3 million policies and serves more than 50 carriers nationwide. The company addresses all types of customer needs and policy requirements—from application processing and underwriting of new business to claims and administration of open and closed blocks. LTCG’s advanced data analytics, actuarial and risk management capabilities and unmatched industry expertise can help organizations manage their business and develop emerging products such as hybrid life/long term care policies. In addition, LTCG provides clients with unique insight about risk management built upon the industry’s largest database of long term care underwriting and claims outcomes. For more information, visit www.ltcg.com.
About Sparkling Logic
Sparkling Logic Inc. is a California-based company leading technology innovation in Decision Management. Its SMARTS™ decision management system empowers business experts and business analysts in organizations that need to automate and improve business decisions. SMARTS uniquely leverages data in the decision management environment to facilitate the capture of business rules in the context of use cases, asses the impact of changes in the decision strategy, and combine decision logic revealed in historical data with business rules based on business policy and expertise.
Learn more about Sparkling Logic at www.sparklinglogic.com.
Sparkling Logic, Sparkling Logic SMARTS, RedPen and BluePen are trademarks of Sparkling Logic, Inc. in the United States and in other countries. Patents Pending.