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Common Challenges in Claim Management 

Claims management is one of the essential parts of the insurance process. It is a critical part of financial planning and dictates how insurance providers handle customer service. The claims management process involves multiple parties and steps, and obstructions at any of these points can significantly affect the result.

Tips for an Effective Claims Management Process

Managing insurance claims is a complex and elaborate process. The claims management process is challenging, and manual processes are laborious and time-consuming. Experts project the global claims management market in health care alone to reach $136.67 billion by 2030. More claims management professionals use technology to improve efficiency, minimize loss and manage the complete claims life cycle. […]

What Is a Risk Management System?

Every industry has inherent risks, and proactive management is crucial for avoiding the consequences. Those consequences often involve monetary loss, but unmanaged risks can also hurt your organization in areas like agility, efficiency and reputation. Manual risk management usually involves outdated systems like spreadsheets and email attachments, but a risk management platform can streamline the […]

A Guide to MMSEA Section 111

If you make payments to Medicare beneficiaries, you are required to report them under Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA). MMSEA supports transparency between payers and Medicare to improve benefits administration, but reporting can be tricky business. You need to set up the right software, identify the right […]

CMS NGHP Section 111 Webinar 12/6/2022 Recap

On December 6, 2022, CMS hosted an online webinar addressing NGHP Section 111 reporting issues. The first half of the webinar covered concerns and points of interest from CMS’s point of view and the second half was a Q&A session fielding attendee concerns.  We heard a varied list of CMS’s concerns with the quality (and […]

That’s Spooky

Given the fact that it’s Halloween, we probably shouldn’t be surprised that we came across a blog the other day called, Insurance Nightmares. Nope. Not making that up. To be more specific, the purpose of Insurance Nightmares is to write about insurance claims. And to be even more specific than that, the purpose is to […]

Subrogation: Cutting Through the Weeds: Part Two

In the first post in this series, we discussed potential claims that might be subrogated in various lines of business. This time around, we’ll take a more general view of subrogation and the importance of managing the intricacies of subrogated claims. Recently, PropertyCasualty360 published an article entitled, “Why subrogation is more than a final box to […]

Clean Up on Aisle Five

Supermarkets are often hard to insure. There are at least three reasons for that: First, the number of coverages they need can be daunting. Second, the number of employees (workers compensation) and customers (general liability) that have to be covered can be even more daunting. Third and most important, the sheer number of claims they […]

Subrogation: Cutting Through the Weeds

You can tell you’re really deep in the claims weeds when you start thinking about subrogation. Since we are deep in the claims weeds, we have to think about it. To put it simply, just in case you’re not deep in the claims weeds, subrogation refers to an insurance company’s seeking reimbursement for the costs of […]

Curiouser and Curiouser

`Curiouser and curiouser!’ cried Alice (she was so much surprised, that for the moment she quite forgot how to speak good English). We thought of that line from Alice’s Adventures in Wonderland when we read a recent article in PropertyCasualty360. The article — “Mitigating risk & reducing employee claims for commercial clients” — said this, in […]