Trends, Best Practices, & Learning Opportunities

Using Technology To Improve Claims Management for Healthcare Payers

A recent research report by MarketsandMarkets, the global market research platform, predicted that North America would account for “the largest share of the healthcare claims management market in 2018”. The report goes on to state that, “the payers segment is expected to command the largest share of the market in 2018”.

The healthcare claims management process is a crucial aspect of the entire healthcare revenue management cycle, whether you look at it from the provider side or the payer side.

There are two major reasons payers experience financial losses due to claims management.

  • Overpaying on claims, which often lead to millions of dollars in losses by the end of the financial year.
  • Penalties because of compliance and regulatory issues.

Process improvements supported by technology can help payers save valuable time and money while significantly improving the payer-provider relationship. Today, information technology-enabled process improvement can help payers in two major ways:

  • Enhancement of workflow: This ensures an easy, fast, and secure flow of information between payers and providers while optimizing the manual processes also. This will also help enhance compliance.
  • Provider portals: When payers take the time to set up a provider portal, it can lead to great dividends. It can help speed up the authorization process so providers don’t spend valuable time pursuing authorizations through fax or phone. When providers know what to expect in terms of documentation required (which will be available on the portal) they will be more likely to submit a complete claim.

One of the easiest and most hassle-free ways that payers can improve the claims management process is to outsource it to an experienced and trusted firm. If the firm has expertise in both the payer and provider areas, it would be even better. This is where Vee Technologies is different from the rest as it is well versed with both the payer and provider industries in the US.

With Vee Technologies, you can get claims management that maximizes your accuracy through process improvement and state-of-the-art technology, as evidenced in this case study.

Getting the lion’s share of the fast-growing healthcare claims management market requires strategic planning. Partner with Vee Technologies and stake your claim on it!