Claims Management Services: Why Your Company Needs Them

Posted by Susan Berndt on June 3rd, 2020
Susan Berndt
Susan is a creative marketing professional with a demonstrated history of working in the hospital & health care industry. Susan joined Smart Data Solutions in 2016 focusing on marketing strategy, campaign execution and creating an inbound marketing funnel. She has over 10 years of marketing/advertising experience and over 12 years of customer service experience.

Managing claims processing in-house can be a lot for a business to handle, and outsourcing is a beneficial solution to combat that. There are numerous reasons for a business to have a professional handle their claims management services.

Why You Should Outsource Claims Management Services

These are just a few of the reasons your company could benefit from streamlining claims management services into one simple platform.

Transferring Over Vendor Relations

It is unlikely that existing claims processes include a simple exchange between two parties, your company, and the provider. In fact, communication must go through multiple channels, like PPO providers, bill review, and cost containment trading partners, plus any members or other providers involved. Companies who offer claims management services are able to take over and streamline all of those communications, so your company doesn’t have to.

Streamlined Claims Processing

Similar to having to communicate with multiple partners and providers, managing all the steps of the claims process often ends up across various portals and systems. Having to transfer data between various gateways is not only tedious, but it puts data at risk of being mishandled or breached. Streamlining these processes into one channel, like our provider portal, eliminates data risk, and speeds up the process in its entirety.

Accurate Electronic Data Interchange

Data entry, image capture, and general EDI at the front end of your company can be costly, timely, have a high turnover, and lack the seamlessness of a professional claims management service. A professional clearinghouse can offer data capture solutions that are streamlined so your company can allot the proper resources elsewhere. Smart Data Solutions use technological solutions to improve quality and efficiency within your data capture processes.

Electronic data interchange does everything from converting paper forms into digital, quality control, automatic member and provider matching, and audits and reporting. It can save your company time and money by removing the conversion of medical records over to a fully automated system. In addition, quality control and auditing ensure accurate data every time, and adjustments can be made to the software to avoid any recurring errors in the future.

Increased Security

Claims management services combine their standard security protocols with your company’s internal security to ensure full coverage and safety of all data flowing through. By streamlining claims management services into one process, it creates one secure gateway to manage all workflows. This helps to eliminate any weak spots and prevents human error by removing much, if not all, of the manual input of information.

Integration Across All Platforms

Every business is going to have its unique networks, tools, and routing regulations. This means every member, group, provider, or facility may have different specific needs. At Smart Data Solutions, we can configure every routing workflow to best suit those needs. Whether it be unique forms, integrating with various systems, and testing situational data, an outsourced claims management company can handle all of those exceptions.

Outsourcing your claims management services will streamline your workflow, boost efficiency, improve accuracy and quality control, and save you time and money so you can focus on other critical tasks at hand.

Smart Data Solutions offers everything from data capture to claims routing to image archiving and retrieval. If your company is looking to automate any aspect of the claims process, we can work with you to fully integrate a faster, more efficient workflow. Fill out our contact form to get in touch!

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