slide 1: How Claims Processing Software Has Transformed
the Medical Benefit Industry Over The Years
Adecade ago processing an insurance claim was a labor-
intensive task. However the increase in technology converted the
process into a digital and automated phenomenon. Gradually the
majority of medical insurance companies hospitals and other
related Third Party Administrators TPAstarted relying on
claims processing software systems to process their claims.
One question that always arrives in the mind of an individual
while signing insurance papers is will the insurance company
pay the claim To all the sceptical people who doubt if investing
in an insurance policy can be helpful the short answer is yes.
According to the studies conducted by ASIC and APRA more
than 90 of claims are paid successfully.
slide 2: This number further increased to 96 in the year 2018. The
unbelievable shift noted in the increase of successful
adjudications is due to the software innovation in the health
insurance industry. In the medical insurance industry it wasthe
use of healthcare claims management software that
skyrocketed the industry’s credibility.
According to the IBISWorld report the total market share of the
claims processing software applications in 2019 is 12 billion
which highlights their large-scale usage. Out of the many reasons
that insurance providers gave to justify the requirement of
insurance claim software is the option to customize.
Why Do Insurance Companies and TPAs Needed to
Automate their Operations
Insurance companies have found that automation and choosing
the right claims processing system for their applications gave
them a lot of flexibility. They were able to access analytical data
better prepare reports and make payments more efficiently. The
whole claim process became automated and transparent which
was beneficial for every party including in the insured. The
business process improved and there was a sudden efficiency in
the medical claim insurance industry. People started trying the
newer claims management software systems and the business
model was a success. With the acceptance of technological
innovations in the medical insurance industry changes occurred
in the traditional claims processing system.
slide 3: Claims Got Automated
Healthcare claims management software started providing full
automation and reporting. For an entrepreneur starting a TPA
what could be better than tools to analyse his data and run his
operation with minimal human resourcesCharts graphs
eligibility checks and all aspects TPA administration are now
supportedwith the new generation of claims software.
Safety and Security of Data Increased
Security was the top priority in the insurance industry. The
advanced claims processing software apps of today are built on
high-speed servers that were both fast and safe. This has made
claims secure for the medical insurance industry. Also because of
high-level accuracy in calculation and reporting there were fewer
chances of human error. The level of security and accuracy
increased threefold in the insurance industry over the past
decade.
Beneficial for Benefits Management
The 2000s have been the era when hundreds of thousands of
individuals were attracted to medical and other sorts of
insurance. This has increased market shares and premium
volume for insurers and has given members the assurance that
they are fully covered and insured and any unforeseen health
events.
slide 4: Speed Became the Root of Competition
Seeing the profit in the insurance claims processing software
industrycompetition has increased which has been both good
and bad for insurance providers. Lighterand easier to use
applications have succeeded where the older platforms requiring
huge resources have faltered. As a result even traditional
insurance large firms shifted to newer claims management
software.
Demand for Remote Access
With workers and offices all over business have demanded that
applications provide built in remote access capability via web
browser or remote connection. Any user whether they process
claims or run the company can now view information reports
and process claims 24/7 from anywhere.
Claims Processing Costs Diminished For Companies
Another important thing that the healthcare claims software
automation did for insurance companies is that it exponentially
decreased their annual expenditure.Fewer number of people were
required to manage the same tasks that once required a whole
team of experts.
slide 5: Who’s the leader in 2019
Due to high competition and various kinds of demands of
insurance companies there are only a few prominent
applications in the claims software industry that really stand out.
Every benefits company or TPA or insurance firm demands
custom features in its claims processing software so that they can
organize their business the way they want. Choosing an
application that provides the option to customize and all the core
required built in functions is the best choice Moreover buying a
single package from a single vendor rather than multiple software
packages is the goal of the modern insurance company or TPA.
Which Healthcare Claims Management Software Should
You Buy
You should aim for the application that that includes all the
industry capabilities in a single package along with speed
security and the option to customize. The Datagenix ClaimScape
software is integrated with features like claims processing
reporting invoicing broker management real-time interfaces
web portals and more. Its combination of speed security and
ease of use are hard to beat In the end the we believe that
ClaimScape system from DataGenix appears to be a superior
option when choosing a claims management and benefits
system.Feel free to contact us anytime with any questions.