Processing claims has historically been a laborious, error-prone process. And that has been the case for insurance firms and healthcare organizations—really any industry that is involved in processing large numbers of claims. Think of piles of paperwork to work through and the need to manually check and verify documentation and update different systems with relevant information. We're talking about a lot of room for mistakes. And generally a very time-consuming process. At least until claims management software solutions came along, automation has helped address and overcome the significant challenges in manual processing, reducing the scope for mistakes and improving the customer experience.
The Old Way: Manual, Slow, and Prone to Mistakes
Under the old (manual) way of doing things, teams would need to check every claim—review any supporting documents—and then enter data into other systems to update claim statuses. For many organizations, the nature of the work meant a lot of repetition. Manual checks to ensure all information was complete & accurate, and checking documentation to ensure all relevant information was captured. Regardless of the nature of the task, the end result was a laborious process. And one open to human error.
The New Way: Automating with Claims Management Software
This is where claims management software comes in. It takes all those manual tasks and, through automation, reduces the volume of work that staff members have to undertake. It allows them to focus on other areas or to make more nuanced decisions in their stakeholder interactions. In essence, claims management software makes the whole claims process much faster and more accurate by automating multiple steps.
How It Works
Automation of Manual Tasks
The software can capture data from relevant claims documentation at the point of submission and automatically enter much of the detail needed into any relevant systems. This avoids a member of your team needing to perform this activity—it saves time and is very much a contributing factor to claim processing accuracy.
Reducing Errors and Improving Accuracy
Automation in claims management software ensures that goals are met with accuracy; to do so, the software system has a series of pre-programmed rules that it can follow. So, if there is a suspicious data point, the software can communicate this with the team member as early as possible. The technology can also cross-reference any claim submitted against other internal data sources or third-party systems.
Accelerating Processing Times
Because you have eliminated a large number of the repetitive tasks involving your team, the processing of a claim is much quicker. Support can be delivered—and a resolution found in minutes or hours rather than days—or even weeks.
Improving Customer Satisfaction
When you can process claims more quickly and accurately, you'll have happier customers. Nobody wants to wait for that insurance check or healthcare reimbursement.
The Bottom Line: Efficiency, Accuracy, and Happy Customer
It all boils down to this: Claims management software makes you look good. When you can automate many of the time-consuming tasks that used to stand in your way—you can help your team work smarter because claims errors are reduced. So it registers fewer rejections, and when you can get things done faster, you and your customers are able to lock into a claims processing faster and get your claims quicker!
