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On October 11, 2023, the Centers for Medicare and Medicaid Services (CMS) published the long-awaited final rule stating how and when the agency will impose penalties when responsible reporting entities (RREs) fail to comply with Section 111 of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA). The final rule will be applicable on October 11, 2024, and the earliest CMS will […]
Has your organization recognized a need to shift from manual processes? Are you interested in streamlining incident reporting, risk management and claims processing? You may be considering investing in a risk management information system (RMIS). An RMIS consolidates all data related to claims, incidents and insurance policies and stores it in a centralized location. It […]
Cloud computing refers to services delivered via the internet rather than on-site hardware or software. The concept of being able to access programs and data from anywhere, traces back to the 1960s, though the term “cloud computing” was not coined until 1997. Today, cloud computing is a tool commonly used by businesses — including organizations that […]
Key performance indicators (KPIs) are metrics used to evaluate and benchmark performance. Their purpose is to help businesses measure and monitor progress toward set goals. If a company looks at its KPIs and discovers it is not on track to reach a specific target, it can then identify and address inefficiencies. In the claims management […]
Your organization’s risk management information system (RMIS) collects and stores incident data, enabling efficient root cause analysis. It allows your company to make quick, informed decisions and take action to prevent future incidents. While a scalable, customizable and intuitive RMIS can help your company manage risk effectively and reduce claim costs, a limited system can lead to […]
Claims management can be a complex and time-consuming process rife with challenges, from ensuring claim data integrity to maintaining contact with claimants. In addition, self-insured organizations and third-party administrators (TPAs) are under significant pressure to process claims as quickly as possible. Regardless of an organization’s current position, streamlining the claims management process is achievable. Purpose-built […]
Outdated software can pose many risks for businesses that rely on accurate data and efficient processes. Systems that do not keep up with changing technologies inhibit smooth operations and create inefficient workflows. Replacing a claims management system that may already be obsolete creates more opportunities for agile processes in your business. It minimizes work disruption, […]
As a business owner, it is important to examine potential commercial risks and implement strategies to deal with them. One efficient approach is purchasing insurance. However, for some businesses, traditional insurance is too expensive or generally incapable of meeting their needs. As a result, self-insurance has become an attractive alternative. But what is self-insurance all […]
Discover the various claim management trends from the field that self-insured businesses, third-party administrators (TPAs) and insurance solution providers must know. Staying up-to-date with the current trends in claim management will position your organization for success. In 2023, as claims processing continues evolving, we unveil the pivotal claims processing trends that will shape your strategies. From streamlining operations to […]
As a business exploring avenues to optimize risk management, the concept of self-insurance presents a compelling opportunity. Self-insurance can result in greater control of your claims and cost savings, but this comes with additional responsibilities. In this post, we’ll review the essential considerations for businesses contemplating self-insurance. Among these considerations, we highlight the significance of […]
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