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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 […]
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 […]
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.
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.
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. […]
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 Manual risk management usually involves outdated systems like spreadsheets and email attachments, but a risk management platform can streamline the […]
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 […]
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 […]
For its most recent edition, Claims ‘R’ Us magazine surveyed 3,467 risk managers across a number of industries. There were only two questions asked in the survey. Here are the questions, followed by the top ten answers to each of them: Question 1: Does your claims software integrate with other data sources across your enterprise […]
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 […]
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