Audit performance evaluation

• US 9,721,303 B2
• Filed: 12/31/2013
• Issued: 08/01/2017
• Est. Priority Date: 12/31/2013
• Status: Active Grant

• Current Assignee: Aon Global Operations Limited (Singapore Branch) (Aon Plc (Spain))
• Original Assignee: AON SINGAPORE CENTRE FOR INNOVATION, SAon Singapore Center for Innovation Strategy and Management Pte. Ltd. (Aon plc)
• Inventors: Galusha, Larry Joe, Combes, Kevin, Braun, Paul
• Primary Examiner(s): Trotter, Scott S
• Application Number:
  US14/144,964
• Publication Number:
  US 20150187012A1
• Time in Patent Office: 1,309 Days
• CPC Class Codes: G06Q 10/06 Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
• CPC Class Codes: G06Q 10/06393 Score-carding, benchmarking or key performance indicator [KPI] analysis
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/00 Finance; Insurance; Tax strategies; Processing of corporate or income taxes
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Audit performance systems and methods can be used to provide objective assessment of the performance of claim administrators. Data from audits performed by one or more insurance broker consultants can be input into the audit performance system, and analyzed, to generate reports that compare the performance of a selected claim administrator to an industry standard level of performance or to one or more other claim administrators.

Claims

1. A system of graphical user interfaces embodied on a non-transitory computer-readable medium and executable on processing circuitry for displaying an objective audit performance evaluation based upon calibrated performance scores, the system comprising:

a non-transitory computer readable medium storing calibration data, the calibration data comprising a set of calibration levels for each criterion of a plurality of criteria;

a basic report graphical user interface, comprising

a claim administrator display region on a user'"'"'s computing device configured for displaying respective cumulative score information for each performance category of a plurality of performance categories, wherein

the plurality of performance categories comprise at least three of the following;

an initial contact and investigation category, an operational issues category, a case management category, a documentation category, a medical management category, a negotiation management category, a litigation management category, and a reserves category, and

the cumulative score information comprises a) a cumulative score, b) a benchmark score, and c) a comparison of the cumulative score to the benchmark score, wherein the benchmark score is one of an industry standard level of performance and a cumulative possible score, and

a comparison display region on the user'"'"'s computing device configured for displaying a series of one or more rows of client-specific score information beneath a series of user-selectable category headings, wherein each category heading of the series of user-selectable category headings corresponds to a respective performance category of the plurality of performance categories, wherein the client-specific score information comprises, for each client of the at least one client and for each performance category of the plurality of performance categories, respective client score information, wherein the respective client score information includes a comparison of a cumulative client-specific score to a client-specific benchmark score, wherein the client-specific benchmark score is one of an industry standard level of performance, and a client-specific cumulative possible score; and

a detailed report graphical user interface, comprising

a plurality of performance evaluation display regions on the user'"'"'s computing device, each performance evaluation display region corresponding to a respective performance category of the plurality of performance categories, wherein each performance evaluation display region is configured for displaying, for each administrator of a plurality of claim administrators, and for each criterion of a subset of the plurality of criteria corresponding to the respective performance category,

at least one of a performance category score, and a comparison of the performance category score to a performance category benchmark score, and a performance category graphical rating indicator;

wherein, upon selection of a particular category heading of the series of user-selectable category headings of the basic report graphical user interface,

instructions, executed by the processing circuitry, cause the processing circuitry to prepare, for presentation on the user'"'"'s computing device a corresponding performance evaluation display region of the plurality of performance evaluation display regions of the detailed report graphical user interface, wherein preparing the corresponding performance evaluation display region comprises

analyzing claim data and claim audit performance data to determine, for each criterion of the plurality of criteria presented in the corresponding performance evaluation display region, the respective performance benchmark score, wherein the performance benchmark score is an industry standard level of performance;

accessing calibration data associated with each criterion; and

for each administrator of the plurality of claim administrators, and for each criterion of the plurality of criteria,

identifying, in the claim audit performance data, the respective performance score of the respective administrator, and

determining a respective performance rating indicator corresponding to a calibration level of the respective calibration data, wherein the performance rating indicator represents a general indication of level of performance in relation to the respective benchmark score and the respective performance score; and

present, on the user'"'"'s computing device, the corresponding performance evaluation display region.

2. The system of claim 1, wherein the performance category graphical rating indicator of each administrator of the plurality of claim administrators comprises at least one of a descriptive icon and a descriptive color representing a general indication of a relative level of performance.

3. The system of claim 1, wherein

the claim administrator display region further comprises a total score information field comprising i) a cumulative total score, ii) a benchmark total score, and iii) a comparison of the cumulative total score to the benchmark total score;

and

the basic report graphical user interface further comprises a performance graph, the performance graph including a graphical indicator of the cumulative total score and a graphical indicator of the benchmark total score.

4. The system of claim 1, wherein the detailed report graphical user interface further comprises:

a plurality of criteria descriptions corresponding to the subset of the plurality of criteria corresponding to the respective performance category; and

for each criteria description of the plurality of criteria descriptions,

a respective performance score, and

a respective benchmark score.

5. The system of claim 4, wherein the detailed report graphical user interface further comprises, for each criterion of the plurality of criteria, a respective graphical rating indicator.

6. The system of claim 5, wherein the respective graphical rating indicator comprises a respective text color.

7. The system of claim 5, wherein the respective graphical rating indicator corresponds to a particular calibration level of the set of calibration levels representing a general indication of level of performance in the respective criterion of the plurality of criteria.