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Health Insurance Claims Processing

Medical bill processing is notorious for being time intensive. With the constant updates to medical practices, coordinating of vendors and external clearing houses, it’s no wonder that claims times can take days, weeks or even months to be cleared. The medical world is under a constant digital transformation, but focusing on these five things can make claims processing a smaller headache for you and your customers.

More Detailed Training

Your claims processing training sets the groundwork for how your team members will work going forward. Be prepared with a detailed, but understandable process for them to follow from the get-go. Providing multiple ways to learn, such as self-guided handbooks, e-learning resources, and in person team lead training can give your team a better holistic understanding of their job function.

Additionally, detailed documentation of job functions and locations of resources can help new and existing employees alike. If you do not already have one, consider implementing a central hub of information should someone ever have a question. This can create more autonomous working tendencies, reduce wait times for customers, and free up your managers to deal with larger, more complex issues.

An Enterprise-Wide Search

The largest bottleneck in claims processing happens when customer service agents are looking or interacting with information. Best case scenario, they need to reference information stored in an entirely different application, meaning valuable time is spent searching for that information. Worst case scenario, the customer service rep needs to find information, and then because of lack of infrastructure integration, must manually enter that into another application. When we think of customers dealing with long wait times, or employees not being able to find information, this is often the root cause.

Rectify that issue using a product like Intellective’s Unity that allows you to search and modify data from across your entire enterprise, all from one location. This means less time searching, less time training, and less time the customers are waiting.

Maintaining Information

Next to long search times, incorrect data, or mismanaged data is the largest time suck within claims processing. Duplicate information can wreak havoc on keeping a concise timeline and coming to the correct conclusion at the end of a claim. Investing time into deleting or merging duplicate information will save you later. Once employees can search across the enterprise for what they need, it’s important to make sure there is only one version of that information. Data governance not only acts as security for your workforce, but for your customers as well.

Transparency Throughout the Customer Process

As we come into 2021 customers value honesty and transparency more than ever. This should be integrated into every part of your business and claims processing steps. Make the customers aware of why something is happening, the time it may take for steps to be complete and own up when your processes may have caused an issue. Being honest along the way will create a feeling of trustworthiness and win your life-long loyalty with customers, even if their interaction wasn’t initially perfect.

Automate When Possible

Automation does two main things. It frees up team members to focus on more customer-focused tasks that require critical thinking skills and decreases the amount of human error in other tasks. Consider investing in tools that can automate parts of the process that provide no real customer ROI such as payment reminders.

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