How Cloud Technology Is Transforming Claims Processing

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 deal with claims processing.

According to the Top Actuarial Technologies of 2022-2023 report, 69 percent of actuaries use cloud computing or storage frequently or often. This is not surprising, as cloud technology offers benefits ranging from increased efficiency to decreased IT-related costs. McKinsey and Company found that the EBITDA run-rate impact of cloud technology on the insurance sector will be as much as $110 billion by 2030.

Like any business wanting to cut costs and boost efficiency, self-insured organizations are harnessing the power of cloud computing to revamp and optimize their claims management process. Here are some of the ways cloud computing is transforming claims processing:

Enables Organizational Optimization

Cloud technology enables self-insured organizations to operate in a way that is not possible with on-premise solutions. Rather than every reporting party adding more claims management responsibilities to a site manager’s workload, cloud technology allows many sites to delegate tasks to the claims adjusters.

When claims-related tasks are seamlessly assigned to the right people, organizations can process more claims without hiring additional staff or taking site managers away from customers and projects. They can envision and incorporate ways to use cloud-based tools to streamline claims management, and ultimately, they can scale faster.

Facilitates Access to Real-Time Data

Self-insured organizations, insurance carriers and Third Party Administrators (TPAs) handle vast quantities of data to process claims, analyze trends and make informed decisions. This data may be stored in databases as part of a legacy system.

The term “legacy system” often refers to outdated hardware or software applications that a company relies on daily. Typically, legacy systems are no longer available for purchase or can no longer receive updates. They may also struggle to handle large data volumes or integrate with external systems efficiently. Without the ability to integrate with new systems and applications, legacy systems maintain siloed databases and hinder efficient workflow.

An alternative is to migrate data and applications to the cloud. Cloud computing outshines legacy systems when it comes to accurate data capture because it enables access to real-time data. Self-insured companies rely on cloud solutions to easily access and share real-time data across departments.

A simple flow of data allows organizations to make informed decisions quickly to mitigate risk, enhance collaboration between teams and prevent errors related to manual data entry. It also enables self-insured organizations to keep employees updated on claim status. For example, our cloud-based claims management solution, Cloud Claims, provides real-time updates on claim status, fostering increased employee satisfaction.

Considering the advantages of real-time data access, it is no surprise that most businesses aspired to have 80 percent of IT-hosting dollars go to the cloud in a 2021 report.

Increases Claims Management Efficiency

Efficiency is the driving force behind successful businesses because it saves time, resources and money while improving customer satisfaction. The same idea applies to claims management. Efficient claims management allows a self-insured business to maximize its time and resources and improve employee morale.

Thanks to cloud-based claims processing solutions, self-insured businesses no longer need to wade through paperwork or get lost in data siloes. Cloud solutions have transformed traditionally sluggish processes into streamlined operations. Here are some of the ways cloud-based software boosts claims management efficiency:

  • Access data anywhere: As long as the users have an internet connection, they can access cloud-based claims management software from a mobile device. This allows companies to initiate risk management actions at the first notice of loss (FNOL) before a claim is even filed.
  • Store data in a centralized location: Cloud-based solutions seamlessly integrate with many types of internal and external software, allowing organizations to keep all data related to claims and incidents in a centralized location. This provides a complete picture of an organization’s risk and claims management health.
  • Easily collaborate with stakeholders: With the ability to centralize data, cloud-based software can provide a single source of truth. This capability means it is much easier to prevent data silos and miscommunication and simplify collaboration among stakeholders.

Cloud Claims also offers additional efficiency-related advantages, as it:

  • Enables self-insured companies to create multiple claims from a single incident.
  • Makes it easy to capture FNOL data remotely and quickly report incidents using customizable fields.
  • Provides automation features, like triggered email notifications, to save time and keep stakeholders informed.

Reduces the Need for On-Premise Infrastructure

On-premise infrastructure requires organizations to keep servers, storage devices and networking equipment on-site. It also requires resources, like time, money and employees to maintain the systems.

Migrating claims management to the cloud reduces the need for on-premise servers, decreasing costs related to keeping and maintaining hardware. According to Nucleus Research, companies see a $3.43 return for every dollar spent on cloud migration. So, while some businesses are hesitant to invest in cloud migration, many recognize that the cloud brings a higher ROI than on-premise solutions.

Adopting cloud-based claims management software can be a quick and painless process, depending on the vendor and type of cloud computing model you choose. Cloud Claims, for example, is a software-as-a-service (SaaS) platform. This means we handle everything related to software maintenance, including implementing automatic updates and offering unlimited tech support.

Promotes Easy Scalability

A business that utilizes scalable resources is equipped to handle rapid growth efficiently. For self-insured organizations, a scalable claims management system is part of that equation.

Some cloud-based claims processing software, like Cloud Claims, are highly scalable due to built-in features such as unlimited storage and customizable templates. Overall, cloud-based software is more flexible than on-premise solutions and allows self-insured companies to scale up or down to meet changing needs.

Simplifies MMSEA Section 111 Compliance

Cloud computing is not just helping self-insured businesses transform how they process claims — it is also revolutionizing how they comply with MMSEA Section 111.

Organizations that make payments to Medicare beneficiaries must comply with reporting requirements under Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007. MMSEA Section 111 reporting can be complex, as it may involve establishing a secure electronic data exchange, collecting detailed information about each claimant and submitting detailed reports. Failure to comply with MMSEA Section 111 reporting can lead to hefty fines.

Fortunately, cloud-based claims management solutions can simplify MMSEA Section 111 compliance by:

  • Allowing your organization to collect, store and access the required documentation easily.
  • Automatically providing a secure data exchange.
  • Reducing human error by decreasing the need for manual processes.

Additionally, your cloud software provider may keep you updated on compliance changes so you do not have to invest too much time in monitoring updates.

We offer MIR Express™️ , a purpose-built, cloud-based solution for Section 111 reporting. To ensure reporting accuracy, MIR Express™ features automated monthly and quarterly reporting submissions and a data pre-validation acceptance rate of 99.9 percent. We keep the product up to date to ensure compliance with MMSEA Section 111.

Choose Cloud Claims to Transform How You Manage Claims

With its ability to increase efficiency, scalability and cost savings, cloud-based claims management software is here to stay. Furthermore, adopting a cloud-based solution can be smooth and hassle-free with the right provider.

For example, Cloud Claims integration and training is a quick process. In some cases, we can have Cloud Claims up and running in a day. We have a 100 percent successful implementation rate, and we will tailor onboarding to your organization’s needs to ensure you feel confident using our SaaS solution.

Ready to learn more? Contact us today to speak with a consultant and schedule a Demo customized to your organization.

 

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