ClaimTECH Blog - MVA Claims Resolution & Beyond

The 5 Most Common Issues with Claims Processing Systems

Posted by ClaimTECH on Sep 13, 2017 2:57:17 PM

 

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Your claims processing system isn’t perfect. It might not even be good. Don’t worry though - you’re not alone. It’s rare to find a claims processing system that has no issues. From the speed of your adjusters to stakeholder communication issues, there’s always going to be a part of your system that can be improved. Continual improvement should be part of any business process. However, in working with insurance companies we’ve repeatedly seen the following five issues with existing claims processing systems.  

  1. Not processing claims fast enough
    In insurance, revenue is heavily dependent on the speed at which adjusters can process claims. However, with increased speed comes mistakes. If adjusters are measured solely on numbers, it’s inevitable that corners will be cut in order to meet deadlines and hit quotas. Cutting corners means overworked employees leading to reduced retention rates, an incomplete claims process, and suboptimal results. Finding the balance that allows you to maximize both the amount of claims being processed and the quality of the work your adjusters are doing is vital in ensuring the profitability and success of your claims processing system.
  2. Too many stakeholders
    MVA claims are getting harder and harder to settle. One of the biggest hurdles in the ability for an insurance adjuster to process claims and do their job is the amount of stakeholders involved in a claim. This could include multiple lawyers, the healthcare providers, and all the stakeholders on your internal team that are involved. More stakeholders means a bogged down process and significantly more difficulty with communication, approvals, and resolving claims. Take a deep dive into who you are bringing into a claim. If there’s opportunity to reduce the amount of stakeholders involved, consider doing so to make your claims processing system leaner and more efficient.

  3. Gaps in communication
    The provider-payer feedback loop is a real thing. We define it as “the continuous dialogue between insurance provider and payer to ensure a mutual beneficial outcome for both parties.” Creating clear lines of communication between all parties, whether through the phone, email, or a platform like ClaimTECH drives better results for all parties. Communication helps set deadlines and expectations while guaranteeing that everyone working on a claim, from provider to lawyer to carrier are on the same page. The goal for all parties working on a claim is the same - to get the claim settled quickly and painlessly, to achieve the best possible result, and for everyone to be satisfied with the outcome. Improving lines of communication helps drive improvement in all of these areas.

  4. No established best practices
    Outdated claims processing systems are often disorganized, unreliable, and missing key features. In large insurance companies, client naming conventions may vary and there may not be a central location for all files. This causes confusion, duplication issues, and efficiency problems throughout the company. Establishing best practices with regards to internal client management, external communication, and everything in between is a key element of a successful business.

  5. Being afraid of technology
    Technology is coming to the insurance industry. There’s no doubt about that. Just ask Business Insider or Insurance Business. It’s one of our seven insurance industry trends to watch for. What you should be asking yourself isn’t if you want to be part of it, but whether or not you want to be a technology early adopter or a technology late adopter. Don’t rely on your existing antiquated systems to be good enough for now. Successful insurance companies are the ones that are adopting new technology as part of their claims processing systems. Unsuccessful companies will be the ones that resist change.

Now think about your existing claims processing system. Do any of these issues sound familiar to you? It could be one, it could be more than one, or it could be all of them. Luckily, all of these issues are solvable. ClaimTECH’s cutting edge platform helps address all five of these pain points while seamlessly integrating into your existing system:

  1. Not processing claims fast enough
    ClaimTECH empowers adjusters to settle more claims faster, increasing claimant and retention rates.

  2. Too many stakeholders
    ClaimTECH does not replace your existing processes. However, it does augment and improve them. This means that the claims process will only be between stakeholders who need to be involved. If you use ClaimTECH at the beginning of the claims process, you may not need 3rd parties who charge you additional fees to settle claims.

  3. Gaps in communication
    ClaimTECH is a high-tech communication platform. In order to facilitate high-speed, mutually beneficial transactions we facilitate high speed communication between all involved parties.

  4. No established best practices
    Leveraging ClaimTECH gives insurance companies a new “best practice” as a place to keep your claims organized.

  5. Being afraid of technology
    ClaimTECH is the type of insurance technology experts are talking about when they refer to the new age of insurance.

If you’re interested in seeing all of the benefits that ClaimTECH has to offer, request a call and demo from our team of claims resolution experts below.

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Topics: Insurance Carriers, Insurance Industry