COVID-19 patient in the hospital. A recent NCCI study found that COVID-19 claims that require hospitalization cost an average of $38,500 each. (Photo: Mongkolchon Akesin/Shutterstock.com)

Two years since the onset of the pandemic, nationwide COVID-19 cases persist and, as of this writing, are entering yet another wave. Carriers have been challenged to quickly become adept at segmenting COVID-19 and non-COVID-19 claims while also managing COVID-19 claims from an operations perspective.

Proper triaging and categorization of COVID-19 claims from non-COVID-19 claims is as important as ever to accurately inform business decisions. For example, by immediately understanding the relative complexity of both COVID-19 and non-COVID-19 claims, a claims team can get the right resources (i.e., senior claims handlers, clinical intervention, etc.) applied to claims as quickly as possible, thereby increasing the probability of an optimal outcome. This includes low complexity COVID-19 cases where prompt attention to minor indemnity and medical payments can help facilitate the rapid closure of pending files.

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