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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 harnessing advanced technologies, this guide will list and explain the top trends in claim processing in 2023 that shape efficient and forward-thinking claim management practices.

Claim Management Trends in 2023

Let’s dive into current trends in claim management and explore the transformative claims processing trends driving innovation and efficiency.

1. Incident-Based Approach — Redefining Claims Management

Amid claim management trends in 2023, one trend stands out — the incident-based approach. Departing from traditional methods, this approach revolves around real-time incident reporting. By promptly ingesting data for informed decision-making, businesses ensure accuracy and relevance.

Cloud Claims, a sophisticated solution for incident-based processing, bolstered this transition. With the ability to swiftly report incidents through smartphones, complete with attached visuals, Cloud Claims pioneers a seamless shift toward efficiency and precision. As businesses embrace this trend, they redefine their claim management landscape, setting the stage for enhanced operational agility and optimal outcomes.

2. Expedited Data Ingestion and Prompt Decision-Making

Timely and accurate data is the foundation for efficient claims processing and technology plays a pivotal role. Harnessing innovative tools, stakeholders can swiftly ingest data, triggering real-time alerts that keep all parties informed. This accelerated flow enables agile decision-making, transforming claims into actionable insights.

By adopting configurable systems tailored to individual client needs, businesses cultivate an environment where prompt, well-informed decisions become the norm. In the claims industry, the ability to expedite data flows and facilitate rapid decisions propels organizations toward operational excellence and heightened stakeholder satisfaction.

3. Configurable Systems — Adapting to Unique Client Needs

In 2023, claim management is shifting toward adaptable and client-centric systems. Every organization operates with its distinct processes, workflows and requirements. Configurable systems offer the flexibility to mold claim management tools according to these individual needs. This trend ensures that businesses no longer conform to rigid, pre-set structures but can instead design seamless workflows that align with their operations.

Cloud Claims offers a purpose-built incident-based claims management system tailored to the intricate demands of self-insured entities, TPAs and insurance providers. This adaptable approach streamlines claims processing and maximizes efficiency, accuracy and client satisfaction. As the industry utilizes this trend, businesses can expect enhanced control, improved outcomes and a competitive edge in claim management.

4. Bridging the Gap — Self-Insured Corporates and Big Insurers

Self-insured entities are no longer confined to antiquated systems or limited by technological constraints. This trend acknowledges the importance of equipping self-insured corporates with the same advanced claims processing capabilities that big insurers have long enjoyed. Cloud Claims plays a pivotal role by offering purpose-built technology tailored to the unique needs of self-insured businesses.

By adopting this trend, organizations can surpass the limitations of email chains, spreadsheets and outdated systems. Cloud Claims empowers self-insured corporates to harness efficient claims handling, data-driven insights and streamlined processes like those of established insurers. This trend ensures that self-insured entities can compete on a level playing field, achieve substantial cost savings and optimize their claims management practices for success.

5. Real-Time Insight and Stakeholder Participation

Looking further into claim management trends, real-time insight and stakeholder participation emerge as central catalysts of efficient and proactive claims processing. This trend redefines the role of corporate stakeholders, enabling them to actively improve safety and reduce loss.

Cloud Claims enable real-time insights, providing stakeholders with a comprehensive view of organizational activities. Stakeholders can make informed decisions, monitor trends and contribute to risk mitigation strategies by actively participating in the claims management process. Real-time insight and stakeholder participation enhance claims processing and foster collaboration, transparency and accountability.

Trusting APP Tech for Incident-Based Claim Management

When it comes to claim management trends, staying ahead is crucial. As insurance solution providers seek effective strategies for 2023, key claim management trends shape these strategies and facilitate informed decision-making. The incident-based approach innovates claims management, while real-time insights and configurable systems expedite decisions.

APP Tech’s Cloud Claims seamlessly blends cutting-edge features with a user-friendly design. By bridging the gap between self-insured corporates and industry giants, Cloud Claims ensures efficient claims processing akin to big insurers. As you navigate these current trends in claim management, remember — Cloud Claims is not just software, it is a partner in simplifying complexity.

Request a Demo today and learn more about incident-based claim management.

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 the Centers for Medicare and Medicaid Services? Simply put, CMS is the federal agency that administers the Medicare and Medicaid programs. These programs provide health care services and coverage to millions of Americans. As a result, the CMS plays a pivotal role in the United States health care system.

In this post, we’ll explore how CMS works and the different programs CMS oversees. We will also provide an introduction to the complex world of Mandatory Second Payer and MMSEA Section 111 reporting compliance.

Roles and Responsibilities of CMS

CMS plays a vital role in administering the Medicare and Medicaid programs and ensuring access to health care coverage for different populations. CMS sets guidelines and regulations to govern these programs, fostering compliance and facilitating health care services.

Regulating and overseeing health care providers participating in Medicare and Medicaid is a primary responsibility of CMS. This involves establishing standards for provider enrollment, care quality and patient safety, and conducting surveys, audits and inspections to monitor compliance.

CMS also manages payment and reimbursement systems, establishing fee schedules, rates and payment methodologies. It strives for fair and accurate payment to providers while controlling costs and preventing fraud and abuse.

To improve health care delivery, CMS implements various initiatives and programs. It promotes evidence-based guidelines, fosters innovation and incentivizes value-based care models to enhance quality.

CMS prioritizes fraud prevention and enforcement. Sophisticated data analytics, audits, investigations and enforcement actions are employed to combat fraud, waste and abuse of taxpayer funds.

CMS collaborates closely with state governments, stakeholders and industry experts. It partners with states to administer Medicaid programs and fosters information exchange and collaboration for innovation and improved health care outcomes.

By fulfilling its roles and responsibilities, CMS ensures effective administration, regulation, and oversight of Medicare and Medicaid. This empowers self-insured entities and insurance solution providers to navigate complexities while delivering high-quality care to their claimants and beneficiaries.

Understanding CMS Programs

Medicare and Medicaid are the two programs administered by CMS. Let’s explore their significance in the health care landscape.

Medicare Program

Medicare serves as a lifeline for eligible individuals, providing essential health care coverage based on specific criteria. To qualify for Medicare, individuals must generally be aged 65 or older, but it also covers certain individuals with disabilities or end-stage renal disease.

Medicare consists of different parts, each offering specific coverage and services:

• Part A: Part of traditional Medicare, Part A includes hospital insurance and covers in-patient hospital stays, hospice care, skilled nursing facility care and limited home health care services.
• Part B: Part B is also part of traditional Medicare, and includes medical insurance and covers out-patient services, including doctor visits, preventive care, certain diagnostic tests and durable medical equipment.
• Part C: Created in 1997, Part C is part of Medicare Advantage and offers an alternative to the original Medicare, providing all-in-one coverage through private insurance plans approved by Medicare. Medicare Advantage plans often include prescription drug coverage (see Part D below) and additional benefits like dental and vision care.
• Part D: Part D, added in 2003, also forms part of Medicare Advantage and provides prescription drug coverage and helps individuals pay for prescription medications, offering a range of prescription drug plans.

Medicaid Program

Medicaid serves individuals and families with limited financial resources, offering access to essential health care services. Eligibility for Medicaid is based on income and other specific criteria, which vary from state to state. The program aims to ensure that vulnerable populations, including children, pregnant women, individuals with disabilities and the elderly, have access to comprehensive health care coverage.

In recent years, Medicaid expansion has been a significant development. Under the Affordable Care Act (ACA), states have the option to expand Medicaid eligibility to cover individuals with higher income thresholds. This expansion has extended coverage to millions of additional individuals who were previously uninsured.

Medicaid provides a broad range of covered services, including, but not limited to, hospital visits, doctor appointments, preventive care, prescription medications and mental health services. The program aims to address the health care needs of low-income populations and improve their overall well-being.

Children’s Health Insurance Program (CHIP)

Medicaid Expansion CHIP, established in 1997, is designed to fill the gap for children who do not qualify for Medicaid but still lack access to affordable private health insurance. The program ensures that eligible children have access to comprehensive health care services, including doctor visits, immunizations, hospital care and prescription medications.

Eligibility for CHIP varies by state, but generally, children in families with income levels above the Medicaid threshold can qualify. CHIP provides coverage to millions of children, ensuring their well-being and providing necessary medical support.

From preventive care to specialized treatments, CHIP covers a broad range of health care services to meet the unique needs of children, promoting their healthy growth and development.

Medicare Secondary Payer (MSP)

Medicare Secondary Payer (MSP) provisions were established in 1980 to shift payment responsibility away from Medicare, in response to concerns over the long-term financial health of the Medicare program. Initially, Medicare was designed to be the primary payer for health care services for eligible individuals aged 65 and older. However, as the program evolved, policymakers recognized the need to prevent Medicare from bearing the full burden of health care costs when other coverage options were available.

MSP refers to a set of rules and provisions established by the U.S. government to determine the order of payment when an individual has health care or injury coverage from multiple sources. The primary goal of MSP is to ensure that Medicare is not the primary payer when other sources of coverage exist. Under the MSP rules, Medicare acts as the secondary payer in situations where another entity, such as an employer group health plan, workers’ compensation, or liability insurance has the primary responsibility for covering health care costs. The primary payer must fulfill its obligations before Medicare pays for any remaining expenses.

In cases where another payer may be responsible, Medicare will make payments for health care services conditionally, known as Conditional Payments. These payments must be repaid to Medicare if a settlement, judgement, or award is made to the Medicare beneficiary in compensation for the injuries.

Additionally, MSP requires claim settlements involving Medicare beneficiaries to take Medicare’s future interests into account. This is done through Medicare Set-Asides (MSAs) arrangements, which reserve funds (i.e. “set them aside”) from a settlement to be used by Medicare to cover future medical expenses.

MSP rules help prevent unnecessary expenditures and preserve Medicare’s financial resources. They require individuals and health care providers to report any other sources of coverage to Medicare, ensuring that the program does not pay for services that should be covered by another entity.

With conditional payments, set-asides, and the many other tools in Medicare’s toolbox, complying with MSP regulations can be challenging, but it is absolutely necessary to avoid penalties and reimbursement demands from Medicare. Many companies and law firms specialize in Medicare Secondary Payer compliance and can provide expert guidance.

MMSEA Section 111 Reporting Fills a Gap for CMS

Although the Medicare Secondary Payer (MSP) provisions were long-established, CMS had no easy way to know when there was another, primary payer available. CMS relied on individual Medicare beneficiaries to alert them to other payers. There was no incentive for an individual beneficiary to do this because, so long as their medical bills were paid, the Medicare beneficiary likely didn’t care how it was paid for. Moreover, in the case of claim settlements, beneficiaries would rather pocket their settlement money than set some aside for Medicare!

This created challenges for CMS in enforcing the MSP statutes. In response, Congress strengthened CMS’s hand with the introduction of MMSEA Section 111 reporting (also known as Mandatory Insurer Reporting). It was created to fill the gap in Medicare’s view, mandating insurers and self-insurers to report information to CMS about the health care coverage of, or settlements, judgments, awards, or other payments to, Medicare beneficiaries. While this reporting serves an essential purpose in facilitating Medicare coordination and compliance, it creates yet another set of compliance challenges because it shifts the burden of notifying CMS of primary payer responsibilities from the individual Medicare beneficiaries to the insurers and self-insureds.

Overall, the implementation of MMSEA Section 111 reporting strengthened the enforcement of the MSP provisions by preventing and improving the identification and recovery of improper Medicare payments. It enhanced CMS’s ability to identify situations where other entities have primary payment responsibility, ensuring that Medicare remains the secondary payer and reducing improper billing to the program.

But complying with MMSEA Section 111 reporting involves following complex technical requirements. Reporting entities must navigate the intricacies of data collection, formatting, and submission through CMS-approved reporting channels. The process demands a thorough understanding of the reporting guidelines and protocols to ensure accurate and timely submissions.

Self-insured entities and insurance carriers may encounter challenges in gathering the necessary data for reporting. This includes identifying and tracking reportable events, collecting beneficiary information, including Social Security number and medical diagnosis information, and reconciling data across multiple systems or entities.

Failure to comply with MMSEA Section 111 reporting requirements can have significant consequences. Non-compliance, including inaccurate reporting, may result in penalties, fines or even litigation.

How an MMSEA Section 111 Reporting Solution Facilitates MSP Compliance

To mitigate these compliance challenges, organizations can consider utilizing MMSEA Section 111 reporting software to simplify and streamline the reporting workflow.

Such software offers a range of features and capabilities designed specifically for compliance with CMS requirements. These solutions provide user-friendly interfaces that guide users through the data collection, formatting, and submission processes. With built in validations and checks, they help ensure the accuracy and completeness of the reports, minimizing the risk of rejections and penalties.

By streamlining the workflow, an MMSEA Section 111 reporting solution can save time and effort. These solutions automate data gathering from internal claims systems, consolidate the necessary information, and generate the required reports to CMS. This eliminates the need for manual data entry, removes the burden of maintaining audit trails, and reduces the likelihood of errors.

Although some companies create their own systems for electronic reporting to CMS, the reporting rules change regularly and keeping home grown systems up to date requires ongoing effort and resources. Therefore, ensuring compliance with CMS reporting requirements is a key aspect of MMSEA Section 111 reporting solutions. These solutions stay up to date with the latest CMS guidelines and regulations, incorporating any changes. This ensures organizations stay compliant and avoid civil money penalties (CMPs).

Lastly, the vendors who provide MMSEA Section 111 reporting solutions can provide expert support and guidance throughout the reporting journey. They offer dedicated customer support teams that are well-versed in CMS reporting requirements. These experts can assist organizations in navigating any challenges, answering questions and providing personalized guidance to ensure successful reporting to CMS.

Unlock the Power of Seamless Reporting With MIR Express^™ by APP Tech

In this comprehensive guide, we’ve explored CMS and its vital role in the health care industry. CMS’s impact is far-reaching, from administering Medicare and Medicaid programs to ensuring quality care and combating fraud. Understanding the complexities of CMS programs is essential for self-insured entities to navigate the ever-evolving landscape successfully.

When it comes to MMSEA Section 111 reporting, APP Tech’s MIR Express emerges as the ideal solution. As a user-friendly, secure, and web-based system, MIR Express simplifies the mandatory insurer reporting process for non-group health plans (NGHP). EDI and API integration options eliminate redundant data entry and can fully automate sending your data to APP Tech. With continuous updates and 100 percent adherence to CMS requirements, MIR Express streamlines data collection, minimizes errors, and maximizes compliance.

By incorporating MIR Express into your reporting workflow, your company can minimize exposure to civil money penalties (CMPs) and streamline claims reporting. Enjoy peace of mind knowing that your reports are pre-validated, ensuring accuracy and compliance. With efficient reporting, your administrative teams gain valuable time to focus on other critical processes.

Request a demo today and unlock the power of seamless, compliant reporting with MIR Express.

 

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 of meeting the demands of today’s digital age. Additionally, as the next generation workforce drives the digital transformation in the insurance consumer industry, the next generation of claim managers expect access to similar streamlined solutions in the workplace.

Enter the role of advanced technology in claims management — a catalyst for streamlined operations, improved customer experiences and cost savings. Leveraging digital transformation, technology revolutionizes the way claims are processed, analyzed and handled.

At the heart of this revolution lies claim management software and advanced claims management systems, empowering its users to simplify and expedite the processing of claims. By automating workflows, integrating with data in existing systems and enabling real-time analytics, technology elevates claims management to new heights.

In this blog, we delve into the pivotal role of technology in claims management, exploring how it reshapes the industry and the benefits it brings.

Traditional Claims Management

Before the advent of technology in claims management, manual processes presented some significant challenges and limitations. These conventional methods hindered efficiency and left room for errors and delays. The following are key drawbacks of traditional claims management that have necessitated the rise of technology in claims management:

• Time-consuming processes: Manual claims management involves time-consuming processes and excessive paperwork. Handling and processing claims manually led to repetitive tasks, data entry and document management — consuming valuable time and resources.
• Inefficiencies and potential errors: Inefficiencies were rampant in traditional claims management, particularly when relying on tools like spreadsheets. These methods lacked automation and validation mechanisms, making them prone to errors and inconsistencies. The complexity of claims portfolios often overwhelmed manual systems, leading to inefficiencies and delays in processing.
• Lack of real-time data and analytics: Traditional methods needed help to provide real-time data and analytics. Access to timely and accurate information is necessary for decision-making to become easier. In contrast to modern claim management software, traditional approaches relied on outdated data and lacked robust analytics capabilities.
• Inefficient communication and collaboration: The reliance on emails and manual coordination slowed down processes, impeding the flow of information between stakeholders. Assigning critical tasks to users only works if done infrequently, otherwise tasks can be forgotten or fail to be reassigned before deadlines are missed.

That said, there are some other common challenges in claim management today that technology-driven solutions can resolve.

The Role of Technology in Claims Management

Technology has revolutionized claims management, empowering those in the claims industry to overcome traditional challenges and enhance operational efficiency. Several technologies have emerged as game-changers in the realm of claims processing:

Claim Management Software

Claim management software platforms are at the forefront of the technological transformation in claims management. These platforms offer a range of features and benefits, which may include:

• Customizable workflows and automation: A claims management system may allow the creation of tailored workflows, automating manual tasks and eliminating redundant processes. This system streamlines claim handling, accelerates decision-making and improves overall efficiency.
• Centralized data management and integration: Modern systems provide a centralized repository for claim-related data, ensuring seamless integration with various data sources. They eliminate data silos, enhance data accuracy and facilitate comprehensive analysis for better decision-making.
• Real-time visibility and reporting: Some claim management software offers real-time visibility into the status of claims, enabling stakeholders to monitor progress, identify bottlenecks and take timely actions. Advanced reporting capabilities provide actionable insights, performance metrics and compliance tracking.

Robotic Process Automation (RPA)

An RPA is another technology transforming claims management. RPA utilizes software robots to automate repetitive and rule-based tasks. In claims management, RPA can perform tasks such as data entry, document extraction and verification, reducing human errors and accelerating claim processing.

Artificial Intelligence (AI)

AI technologies, including machine learning and natural language processing (NLP), have a profound impact on claims management. AI-powered algorithms can analyze vast amounts of structured and unstructured data to identify patterns and predict future trends. AI-driven chatbots and virtual assistants also enhance customer interactions, providing quick responses and personalized support.

Big Data

The exponential growth of data in the digital age has led to the emergence of big data analytics in claims management. By harnessing large volumes of structured and unstructured data, insurers can gain valuable insights into claims trends, risk assessment and pricing models. Big data analytics enables proactive decision-making and predictive modeling for better claims management outcomes.

The role of technology in claims management is multi-faceted, offering streamlined workflows, centralized data management, real-time visibility, automation, AI-driven intelligence and big data analytics.

The Benefits of Modernizing Technology in Claims Processing

In the ever-evolving landscape of claims management, technology continues to play a pivotal role, driving significant advancements and delivering a wide array of benefits. Let us explore the future of technology in claims management and how it simplifies and expedites the ingestion of claim data and enhances overall efficiency.

1. Streamlined Processes and Improved Efficiency

Technology-driven claim management software and systems revolutionize the way claims are processed. By automating manual tasks and providing an intuitive user interface, technology expedites claim processing. Users can easily input claim data, including pictures taken in the field, to accelerate the entire process. Key events and tasks are promptly alerted, ensuring timely actions and preventing delays.

2. Enhanced Data Management and Analysis

Technology empowers claims professionals with robust data management and analysis capabilities. Claims management systems efficiently capture and store data, allowing for easy retrieval and analysis. Risk managers can leverage comprehensive reporting data to identify future trends, patterns and potential risks. This data-driven approach helps mitigate risks effectively and make informed decisions.

3. Improved Client Satisfaction and Service Delivery

By leveraging technology, claims management processes become more client-centric, resulting in improved client satisfaction and service delivery. Technology-enabled platforms provide users with self-service options, granting them quick access to claim information and status updates. This transparency enhances communication and collaboration between claims professionals and clients, fostering stronger relationships.

Embrace the future of technology in claims management to simplify and expedite your operations. Invest in cutting-edge claim management software and systems that enable efficient claim data ingestion, streamlined processing and robust reporting capabilities.

The Future of Technology in Claims Management

As we look into the future of technology in claims management, the possibilities are vast. Insurtech continues to evolve, presenting new opportunities to enhance the claims process and customer journey.

We can anticipate exciting advancements in AI, estimating software and other technologies that will further streamline operations and improve the overall claims experience. Embracing these innovations will empower those in insurance and risk management to stay ahead of the curve, delivering efficient and customer-centric claims management.

Elevate Your Claims Management With Cloud Claims by APP Tech

Discover the transformative power of technology in claims management with Cloud Claims, an incident-based, claims-focused risk management information system (RMIS) by APP Tech. This innovative solution empowers self-insured entities, TPAs and insurance providers to streamline and expedite claims processing.

Cloud Claims’ incident-based design enables companies to log any incident, even without associated claims, providing valuable risk management insights. By identifying patterns and mitigating risks, self-insured companies can cut claims costs and enhance overall risk management strategies.

Experience the benefits of Cloud Claims, including streamlined claims processing, prevention of data duplication, time savings, greater oversight, complete customization and user-friendly reporting capabilities. With its cloud-based accessibility, all stakeholders can access the platform, receive alerts and ensure regulatory compliance.

Learn more about Cloud Claims today to elevate your claims management practices. Contact APP Tech for more information about this user-friendly and secure claims management solution. Unleash the full potential of technology in claims management and drive efficiency in your operations.

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.

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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.

Outside of digitalization, many in-house methods and tips for claim management can help insurance organizations elevate their processes and provide higher customer satisfaction. As expectations change, claims management must be faster and more comprehensive.

What Is Claims Management?

Claims management identifies, authorizes and resolves insurance claim demands to recover losses. Claims management professionals are responsible for processing claims and handling clients during stressful and vulnerable times.

Traditional claims management involves filling in forms and manual investigations, which can cause delays in authorization and challenges in managing risk. Digitization has brought new processes to claims management, providing transparent, streamlined options from a user-friendly interface. Still, effective claims management relies on systematic processes to provide a satisfactory customer experience.

Claims Handling Tips

The delays are among the most significant challenges in the claims management process. Therefore, effective claims management requires streamlining. Quickly resolving claims is the primary goal for insurance staff and claimants.

Here are some tips for claims management effectiveness.

Enhance Your Team’s Performance

The claims management process requires a team to work together to improve efficiency. Consider how your team members — specifically, your adjusters — perform their roles. What are the benchmarks within your organization? For example, consider how familiar your team is with your policies and protocols.

Take an honest look at where your team is now, so you can set new goals and begin to optimize. Ensure you provide your adjusters with comprehensive training and place them in roles that match their unique strengths. Pay attention to what your staff needs to streamline their processes. Claims management software designed for the adjuster frees them from mundane and repetitive work, providing more employee satisfaction and engagement.

Use Your Data and Technology to Your Advantage

As your team processes claims, they will gather essential data. You should gain actionable insights from those details to streamline your claims process, identify unusual claims and provide you with the information you need for effective decision-making.

Integrating the appropriate software can make your claims management processes considerably more effective. Consider claims management software that offers an incident-based approach to data collection. It provides a bird’s-eye view of your organizational processes, claimant trends and metrics that can guide your team and department to further effectiveness.

Prioritize Your Management

The claims management process has many moving parts — adjuster notes, police reports and customer demands. Several people must review all the information before awarding the claim. Additionally, without the ability to coordinate tasks and reminders across team members, you will risk missing critical deadlines and damaging your firm’s reputation.

A comprehensive claims management system will help your team track where a claim is in the overall process, what actions to take and who is responsible for them. Your team will also have all the necessary information to complete their assigned tasks. This data will help your department stay on track to its efficiency goals.

Take Your Time With Each Claim

Ensure your customer service remains a priority in the face of pressure. Lack of attention could lead to your team overlooking critical details. Assign claims to the most suitable adjusters based on the claim’s complexity and the adjuster’s experience level and provide ongoing coaching and mentoring to team members.

Providing your team with mentorship and open communication channels can help foster collaboration within your team and empower them to make meaningful contributions to the department.

Comply With Relevant Regulations

The claims management industry is subject to many regulations. Every step in the process requires complete adherence to avoid invalidations. Your methods must align with the relevant regulations, and manually intensive processes increase the risk of accidental non-compliance.

Just as your methods must comply with regulations, they must be completely transparent to your customers. Showing you follow the rules fosters trust in your procedures.

Invest in the Best Technology

Customer needs have changed recently, and they expect expedient responses to claims. An application where customers can access your claims management services from their mobile devices is essential to maintain a competitive position in the industry.

Claim adjusters can also benefit from a mobile application. It allows them to access real-time data, regardless of their physical location, to settle claims quickly and efficiently.

The Benefits of Claims Management Software

Effective claims management requires you to streamline and digitize your processes. This process eliminates manual inputs and investigations, which are time-intensive and prone to human error. Claims management and compliance reporting software solutions have many benefits.

• Reducing costs: Streamlining your workflow, maximizing efficiency with an adjuster-centric interface and providing customers faster resolution times will reduce your costs in the long run.
• Improving customer service: With the ability to provide real-time insights into a claim’s status and provide a self-service function, your customers can look forward to faster resolutions and comprehensive service.
• Streamlining processing efficiency: Automation can reduce unnecessary processes and increase efficiency. Automating notifications and document requests helps your team stay on track with claims and reduce their time on each one without sacrificing precision.
• Standardizing processes: Claims management often involves multiple parties. Introducing standard processes and integrating your software with other data sources eliminates discrepancies as information passes to different parties throughout the claim.
• Improving security: Claims management software complies with personal information protection laws, so you can assure your customers that you have protected their data from cybersecurity threats.

 Streamline Your Claims Management Processes With APP Tech

The claims management process is a time-consuming and labor-intensive task. As a claims management professional, ensuring your company’s operations are efficient and effective to reduce the claim life cycle and resolve disputes is vital. APP Tech’s Cloud Claims solution can help streamline your claims management process by tracking claims activity and centralizing all your documentation in one location.

Our claims management solution boasts an incident-based architecture, providing stakeholders with real-time insights so they can correct, mitigate or prevent risky claims. For self-insured organizations, third-party administrators, mid-size carriers, or even firms looking to reduce your overall exposure to risk, integrating APP Tech’s Cloud Claims offering into your current strategy ensures your processes comply with claims management best practices.

If you want to learn more about our innovative claims management software solution, please contact us today. One of our solution consultants will be in touch to answer any questions and schedule a demonstration.