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Claim Management Trends From the Field

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 […]

Should Your Company Consider Self-Insurance?

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 […]

The Centers for Medicare and Medicaid Services and Mandatory Second Payer Explained

Having a comprehensive understanding of the Centers for Medicare and Medicaid Services (CMS) is crucial for stakeholders across a range of industries, from health care providers to liability and worker’s compensation insurers. Self-insured entities, third-party administrators (TPAs) and insurance solution providers need to navigate the CMS landscape to ensure compliance, streamline operations and mitigate risks. But what is […]

Data Analytics In Claims Processing: Everything You Need To Know

In the complex realm of insurance, claims processing is crucial in managing risks and providing timely resolutions. However, traditional methods are often plagued by inefficiencies and limited insights. That’s where data analytics comes in. Data analytics in claims processing revolutionizes the landscape, enabling self-insured entities to prevent and mitigate losses efficiently. Organizations can enhance operational effectiveness, […]

The Role Of Technology In Claims Management

Digital Modernization of Claims Management In the ever-evolving landscape of insurance, claims management stands as a critical function for self-insured entities, third-party administrators (TPAs) and insurance solution providers. Claim management involves the efficient handling of claims, ensuring timely resolution and mitigating financial risks. However, with the increasing complexity and diverse portfolios, traditional systems fall short […]

How to Mitigate Risk With an Incident-Based Approach to Claims Processing

As businesses face growing risks and potential losses, effective claims processing is crucial for managing and mitigating those risks. However, traditional claims processing methods often focus on managing claims after they occur rather than preventing them from happening. An incident-based approach to claims processing can help businesses identify and address potential risks before they escalate […]

How to Choose Claims Management Software

Choosing the right claims management software can be a crucial decision for businesses that deal with a high volume of claims. With so many options available on the market, it can be challenging to identify the software that meets your specific needs.

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 […]