Claims processing focuses on prompt customer service, so timing is crucial. The goal is to reduce customer service inquires, facilitate communication between representatives and departments, and resolve the claim as quickly as possible.
Claims processing and claims administration is very paper intensive and has a large number of supporting documents that may be associated with a claim all coming from a variety of sources. This paper must be handled by different resources and may require comparison of records generated via paper, fax, email and/or electronic files. This type of manual paper solution is difficult to audit and challenging for reporting purposes.
Highly distributed environments where branch offices receive claims but the processing is handled at a central location, are even more challenging. Prompt-payment regulations also increase the importance of fast and efficient claims processing.
Consequentially, many other challenges arise with this substantial amount of information; such as how to effectively collaborate, secure, distribute, duplicate, share, store, retrieve, and potentially destroy these business critical documents.
Another organizational challenge presented to processing claims is how to reduce the cost of operations, when many insurance firms are located in expensive real estate locations. Why waste money on expensive office space filled with filing cabinets? What if thousands of files could be reduced to a few gigabytes of space for electronic storage and you used the office space for people not paper?
Workers processing Healthcare Claims, Insurance Claims, Damage Claims, etc. can benefit from an environment where all information can be accessed from a single source; instead of chasing down physical and electronic records distributed around the enterprise and within a variety of repositories.
Claims processing software as part of Enterprise Content Management (ECM), specifically document management with workflow, is an ideal solution for these challenges.