About Medical Claims Process Automation

About Medical Claims Process Automation

One more automation software in the market! Is it really needed? Enterprise software and office automation is now commonplace in the corporate landscape. With new technology solutions propping up every day, the question is do businesses need one more tool to get work done? The answer is YES! Technology enables enterprises. Businesses may not need another software tool to replace an existing one but what they definitely should look to build is a ‘connected enterprise’. A ‘connected enterprise’ at its most basic level builds a synergy between people, processes, and systems to enable the continuity of work and workflows within a company. Connected enterprises today employ embedded systems and wearables, Internet of Things (IoT), intelligent automation, AI and Machine Learning to create a collaborative work environment.

Greater Collaboration at Work

Digital transformation is a natural trajectory for growing organizations and a step forward in the establishment of a connected enterprise. Digital transformation technologies including AI, Machine Learning, Business Process Automation, Intelligent Document Capture, etc., when combined with Robotic Process Automation, create an intelligent process automation platform that can automate an entire process chain.

We’ll look at one such process chain in the insurance sector that can benefit immensely from intelligent process automation and why businesses shouldn’t hesitate to invest in this technology.

Medical Claims Processing Software

Medical Claims Processing Software

Medical claims processing is a critical aspect of insurance claims management and must be done right for the insurers to be in good standing. Done wrong, insurance firms could not only lose out on prospective clients in the future but also incur millions in claims processing costs due to mismanagement of claims. Insurers must operate with a steady hand to ensure sound management of medical claims as well as their longevity in the market. Today, intelligent automation provides this steady hand to the insurers.

First, let us get some figures on record:

  • 8 million claims forms/pages processed per month
  • Identification and data extraction from UB04 forms grows from 0 to 85-90 percent
  • 50% reduction in repeat keying in case of faulty claims
  • Greater accuracy in claims processing even with a reduction of 1-2 personnel per week

These are the results obtained from a leading healthcare insurer that chose to automate its claims processing function using intelligent process automation.

But the biggest advantage a claims processing software with digital transformation capabilities has is that it provides a single unified platform for insurers and providers to meet on and build an integral connected system of medical claims management and patient care. This outsourcing firm has successfully integrated its healthcare scheduling solution with claims processing software to establish a complete suite that connects doctors, insurers, and patients under one roof — a single integrated healthcare platform solution coordinates between clients, insurance companies, and providers for the filing of medical claims as well as payment to doctors.

Intelligent automation naturally creates a healthcare ecosystem where all parties invested in patient care can come under one umbrella solution to enable affordable care to all.

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