How DOCOsoft keeps your claims processing on track
The Writeback message
Ever wondered how claim information entered by brokers gets into your DOCOsoft CMS? Well, unless your business is focused purely on run off, that claim information arrives in the form of a Writeback message.
The history of Writeback starts way back in 2015. Writeback messages were created as part of a broader claims modernisation initiative. Its aim was to allow carriers to operate entirely from within their own systems, removing the need to log on directly to the central systems provided by Xchanging/DXC (ECF). The project enabled carriers to view documents that had previously only been available in ECF and the IMR using their own systems – and to respond to claims 24/7.
Writeback messages start with the broker. Whenever a broker logs on to ECF and adds, amends, or deletes claim information, a Writeback message is created and sent to all relevant parties listed on that claim. Claims activity completed by a DXC technician can also trigger a Writeback message.
Keeping track of claims information
Each Writeback message contains a message sequence number. This message sequence number is maintained for each carrier code registered to receive Writeback messages.
The DOCOsoft CMS has inbuilt monitoring that ensures that, if a message sequence number comes in out of sequence, the DOCOsoft Support Team, will automatically receive an email alert. Even with all the technology available to us in the twenty-first century, a claim or claims workflow trigger (CWT) may sometimes take slightly longer to arrive. So how do we deal with this?
Every few minutes, the DOCOsoft CMS processes any new Writeback messages received from DXC. Each time this Writeback process runs, the CMS checks to make sure every sequential message has been received. If there is a message missing from the sequence, an email alert will be generated and sent to the DOCOsoft Support Team, whose members continually check for alerts during core business hours.
If a message is flagged as missing, the Support Team allows a brief grace period (recognising that it can take time for claims messages to find their way from DXC to the CMS). But if the message fails to arrive within that time-limited grace period, we send a request to DXC asking for the missing message to be resent. We’ll then continue chasing DXC until either the missing message arrives at the gateway and processing continues, or DXC advises us that there is some issue with the message that’s stopping it being processed (at which point, the DOCOsoft Support Team will ‘lock’ the claim – more on this below).
Locked claims
You may occasionally come across a claim in the DOCOsoft CMS that shows a warning message highlighting that the claim cannot be processed. If a claim has been locked, any transactions received for that claim will show the same error message.
Claims can get locked for two main reasons. If DXC is unable to replay a message, then the Support Team will manually lock the claim. This allows the DOCOsoft CMS to continue to process the next message sequence. If a Writeback message comes in for a claim that cannot be processed, the CMS will automatically lock it. This allows subsequent messages for that carrier code to continue processing and ensure that claims handlers will continue to receive claim notifications.
When a claim is locked, all transactions under that UCR will also be locked. The CMS displays a warning advising handlers when a claim is locked and cannot be responded to.
Monitoring locked claims
As you would expect, the DOCOsoft CMS has a built-in feature that monitors and reports any locked claims once processing at DXC has completed for the day. A daily ‘reconciliation email’ is automatically sent to the team. This shows the UCRs for any locked claims and the number of transactions impacted.
Resolving locked claims
Here at the DOCOsoft Support Team, we don’t like to see locked claims. It pains us to see the poor things traps in the messaging equivalent of prison. More importantly, as long as a claim is locked, claims handlers cannot respond to it. This is undesirable for many reasons, not the least of which is the risk it creates of breaching SLA agreements with Lloyd’s. So, every morning the team sweeps up any locked claims and attempts to get them back on track.
There are several ways of doing this. Sometimes simply resetting the status of the message and asking the CMS to reprocess the Writeback message can be enough to get the message processed. But if that doesn’t resolve the issue, we can always revert to the good old-fashioned method of using the CWT files to process the message manually.
It’s perfectly possible you’ve never seen the message in the DOCOsoft CMS warning that the claim you are trying to respond to is locked. If so, that’s great, it means the DOCOsoft Support Team has managed to resolve any issues quickly, behind the scenes, as if by magic!
As a team, we’re highly motivated to make sure claims messages get into the DOCOsoft CMS in a timely fashion, so your claims handlers can respond to those claims as quickly as possible. We very much hope you’ll never see that warning that a claim is locked. We would always rather fix things first, before you even notice that there was an issue!
- Paula Wright, Client Technical Service Delivery Lead
After completing a Masters degree in Business Information Technology, Paula worked in a variety of roles with Web Connectivity, Lloyd’s and LIMOSS, before joining DOCOsoft in April 2022. When it comes to London market claims technology, Paula has the knowledge, the insight and the connections to get things fixed fast for DOCOsoft clients. She and the DOCOsoft Support Team are a trusted source of information and solutions whenever technical issues arise.