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6 Key Performance Indicators in the Claims Process

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 […]

Signs That It’s Time to Switch RMIS Providers

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 […]

Strategies for a Smoother Claims Management Process

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 […]

A Guide to Replacing Your Legacy Claims Management System

Outdated software can pose many risks for businesses that rely on accurate data and efficient processes.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, […]

A Guide to Self-Insurance

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 […]

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 […]