When it comes to managing claims, medical providers have always worked in the dark. A fundamental lack of transparency into the claims management process has limited what providers can see into the process. It’s meant that providers haven’t been able to identify claims for payment that they should be getting paid on. However, the status quo is changing fast with the rise of insurtech. New claims management platforms are changing the future of insurance and providing providers with insights they’ve never had in the past.
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.
There’s a problem in the insurance industry. Delays in communication, multiple layers of 3rd party interest groups such as attorneys and insurance representatives, and inefficient workflows have been causing long, drawn out processes, partial payments, and market inefficiencies. Communication issues have especially driven wedges in what we call “the provider-payer feedback loop”. The provider-payer feedback loop is the continuous dialogue between insurance provider and payer to ensure a mutual beneficial outcome for both parties. Leveraging innovative claims management software will help to close those gaps and push an outdated industry to begin to adapt with modern technology.
New insurance industry trends will be affecting millions of people as we move deeper into the digital era. From economic and labor tendencies to innovative technology, new insurance industry trends are something to keep an eye on. Here’s 7 trends in the insurance industry to watch for:
Why third party liability MVA medical claims are financially eating hospitals and auto insurance carriers alive.
No one saw it coming...Who could have guessed that third party liability MVA medical claims would become increasingly problematic and woefully expensive for the hospitals that treat accident victims and the national auto insurers that pay for it?
Medical costs are rising significantly, and this is particularly true for hospital trauma centers. MVA medical claims range from $500 to $50,000, even for simple, low impact accidents, a.k.a “fender-benders.”
If you’re an adjuster or a manager of adjusters, and you’re looking for greater efficiency in the MVA claims process, this blog is for you.
We’ve spoken to your colleagues to discover what a “day in the life” of a claims adjuster looks like and we’ve interviewed industry experts and healthcare providers to try to better understand what pain points you’re experiencing, all in the hopes of optimizing the claims settlement process for you.
As a claims manager you are tasked with endless responsibilities. Managing your adjusters, who are loaded with stacks of 3rd Party MVA claims, seems to be a never-ending battle. Upper management places pressure on you and your team to keep claims moving through the queue, while adjusters’ hands are often tied with only limited options for resolution. More often than not, these options result in minimal carrier savings, and prolonged efforts.
The following tips will help you overcome challenges presented during the claims resolution process, allowing you to focus on settling claims and saving money.