Claims Experience

1. Log into the system, and ensure you are in the correct Group Name. 

***Type in at least 3 letters to generate the drop down list of available groups.

If your group is not currently in the system you will need to Add a New Group.

2. Click on Claims Experience from the top menu:

3. To add a new Claims period, click on Add Claims Period

4. Complete the following data: 

• Enter the Start Date and End Data of the Claims Booklet(s) period you will be uploading. 
• Check the benefits included in your Claims Booklet and enter in the TLR (Target Loss Ratio)
• Choose the Insurer name (autogenerated list will populate), Policy Number, and Renewal Month.
• Upload the group's Claim Booklet(s) - (the same report you receive from their Carrier) PDF or Excel format.
• Click Save. 

4. Our CloudAdvisors team will Audit the data and send an email once the Claims Experience is ready for review and report generation. Please wait 1-3 business days for confirmation email.  

5. Once the data has been released, and the confirmation email received, revisit the Claims Experience page to review the data under Edit:

9. Review the Claims Details, Premiums, Expenses, Top Drugs etc. You can update or enter a custom Executive Summary for your client.

10. Once all edits are Saved - click Generate Report. You will have the option to generate a Comparison Report by selecting a previously entered period for this group. Or click Skip & Generate Report. 

11. Your Claims Experience Report will generate within 5 minutes and be available under Reports: How to Access Reports

Sample report data:

For additional questions, please connect with [e-mail]